子宫肌瘤、不孕症与腹腔镜子宫肌瘤切除术
Fibroids, infertility and laparoscopic myomectomy.
作者信息
Desai Pankaj, Patel Purvi
机构信息
Department of Obgyn, Medical College and S.S.G. Hospital, Baroda, India.
出版信息
J Gynecol Endosc Surg. 2011 Jan;2(1):36-42. doi: 10.4103/0974-1216.85280.
OBJECTIVE
To review the literature and summarize the available evidence about the relationship of fibroids with infertility and to review the role of laparoscopic myomectomy in infertility.
MATERIALS AND METHODS
Medline, PubMed, and Cochrane Databases were searched for articles published between 1980 and 2010.
RESULTS
Fertility outcomes are decreased in women with submucosal fibroids, and myomectomy is of value. Subserosal fibroids do not affect fertility outcomes, and removal may not confer benefit. Intramural fibroids appear to decrease fertility, but the results of therapy are unclear. Although pregnancy rates for women with leiomyomata, managed endoscopically, are similar to those after laparotomy, there is a risk of uterine rupture. The risk is essentially unknown. Finally, the risk of recurrence seems higher after laparoscopic myomectomy compared to laparotomy.
CONCLUSIONS
Laparoscopic myomectomy, when performed by an experienced surgeon, can be considered a safe technique, with an extremely low failure rate and good results in terms of the outcome of pregnancy.
目的
回顾文献并总结有关子宫肌瘤与不孕症关系的现有证据，以及探讨腹腔镜子宫肌瘤切除术在不孕症治疗中的作用。
材料与方法
检索Medline、PubMed和Cochrane数据库中1980年至2010年间发表的文章。
结果
黏膜下子宫肌瘤患者的生育结局降低，子宫肌瘤切除术具有价值。浆膜下子宫肌瘤不影响生育结局，切除可能并无益处。肌壁间子宫肌瘤似乎会降低生育能力，但治疗结果尚不清楚。虽然经内镜治疗的子宫肌瘤患者的妊娠率与剖腹手术后相似，但存在子宫破裂的风险。该风险基本未知。最后，与剖腹手术相比，腹腔镜子宫肌瘤切除术后复发风险似乎更高。
结论
由经验丰富的外科医生进行腹腔镜子宫肌瘤切除术时，可被视为一种安全的技术，失败率极低，妊娠结局良好。
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