Li Lei, Leng Jin-hua, Lang Jing-he, Liu Zhu-feng, Sun Da-wei, Zhu Lan, Fan Qing-bo
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730, China.
Zhonghua Fu Chan Ke Za Zhi. 2010 Aug;45(8):588-92.
To investigate the characteristics and trends of surgical management on endometriosis in Peking Union Medical College Hospital From 1983 to 2009.
The medical documents of patients with endometriosis diagnosed by surgical pathology were studied retrospectively in Peking Union Medical College Hospital (PUMCH). The ratio of different surgical approaches (laparoscopic and laparotomic surgery) and surgical categories (conservative, semi-radical or radical surgery) were compared in all the cases with endometriosis to investigated alterations trends of approaches and methods of surgery.
Totally integrated records of 13 972 patients underwent surgeries on endometriosis were reviewed and consisted of 24.974% (13,972/55,945) of all gynecologic surgeries. 59.490% of cases (8312/13,972) were treated by laparoscopic approach, which were significantly higher than the rate of 37.700% (15,824/41,973) of laparoscopic approaches in the other gynecologic diseases (P < 0.01). The proportion of laparoscopic surgeries in all endometriosis surgery was 67.31% (947/1407) between 2005 and 2009, which were significantly higher than 55.98% (510/911) of laparoscopic surgeries between 2000 and 2004 (P < 0.01). Conservative surgery (i.e., with uterus and ovaries intact) consisted of 64.014% (8663/13,533) of endometriosis surgeries. The proportion of conservative surgeries was 66.24% (4176/6304) between 2005 and 2009. The proportion of laparoscopic approaches consisted of 81.10% (7026/8663) of conservative surgeries and 26.30% (1281/4870) of semi-radical or radical surgeries (P < 0.01). The average number of annual surgeries, the average number of annual laparoscopic surgeries and its proportion in endometriosis, and the average number of annual conservative surgeries and its proportion in pelvic endometriosis between 2005 - 2009 were all increased significantly than those at range of 1983 to 1999 and 2000 to 2004. The rate of severe complication 0.351% (49/13,972) was observed in all endometriosis surgeries.
Surgery was the major treatment of endometriosis in PUMCH, laparoscopic surgery was the major approach and conservative surgery was the major surgery type.
探讨1983年至2009年北京协和医院子宫内膜异位症手术治疗的特点及趋势。
回顾性研究北京协和医院经手术病理确诊为子宫内膜异位症患者的病历资料。比较所有子宫内膜异位症病例中不同手术方式（腹腔镜手术和开腹手术）及手术类型（保守性、半根治性或根治性手术）的比例，以研究手术方式和方法的变化趋势。
共回顾了13972例接受子宫内膜异位症手术患者的完整记录，占所有妇科手术的24.974%（13972/55945）。59.490%的病例（8312/13972）采用腹腔镜手术，显著高于其他妇科疾病腹腔镜手术率37.700%（15824/41973）（P<0.01）。2005年至2009年所有子宫内膜异位症手术中腹腔镜手术的比例为67.31%（947/1407），显著高于2000年至2004年的55.98%（510/911）（P<0.01）。保守性手术（即子宫和卵巢完整）占子宫内膜异位症手术的64.014%（8663/13533）。2005年至2009年保守性手术的比例为66.24%（4176/6304）。腹腔镜手术在保守性手术中占81.10%（7026/8663），在半根治性或根治性手术中占26.30%（1281/4870）（P<0.01）。2005 - 2009年每年手术平均例数、每年腹腔镜手术平均例数及其在子宫内膜异位症中的比例、每年保守性手术平均例数及其在盆腔子宫内膜异位症中的比例均显著高于1983年至1999年及2000年至2004年期间。所有子宫内膜异位症手术中严重并发症发生率为0.351%（49/13972）。
手术是北京协和医院治疗子宫内膜异位症的主要方法，腹腔镜手术是主要手术方式，保守性手术是主要手术类型。
