Department of Gynecology, Changzhou No. 2 Hospital, Affiliated with Nanjing Medical University, Changzhou, China.
Eur J Obstet Gynecol Reprod Biol. 2012 Sep;164(1):74-8. doi: 10.1016/j.ejogrb.2012.05.015. Epub 2012 May 30.
To evaluate the efficacy and feasibility of finger-assisted laparoscopic myomectomy for multiple myomas.
A total of 565 patients with symptomatic myomas underwent finger-assisted laparoscopic myomectomy between January 2006 and March 2011 to remove multiple myomas at our center. Laparoscopic myomectomy technique was modified, and involved the insertion of two fingers into the vagina to elevate the uterus, while one or two fingers of the other hand were inserted into the abdomen through a suprapubic 15-mm trocar port for palpation of small myomas, which did not distort the uterine contour.
The mean (SD; range) patient age was 38.26 years (5.84; 25-48 years). The diameter of the largest myoma in each case was 6.13 cm (1.21; 4-15 cm). The total number of myomas enucleated in the initial enucleation was 2228. There were 597 additional myomas enucleated with finger-assisted guidance. The mean diameter of the additionally enucleated myomas was 1.1 cm (range, 0.2-2.5 cm), which was significantly smaller than those of the initially enucleated myomas (p=0.002). The mean operative time was 97.1 min (30.2; 35-180 min). The decrease in postoperative hemoglobin concentration was 1.6g/dL (0.7; 0.4-3.2g/dL). During the operation, no patients required a blood transfusion. Six patients developed postoperative fever. There was no occurrence of bowel or urinary tract injury. The mean postoperative hospital stay was 3.2 days (0.9; 2-6 d). All procedures were successfully completed without the need for laparotomy.
Finger-assisted laparoscopic myomectomy is a feasible and safe approach in the surgical treatment of multiple myomas.
评估手指辅助腹腔镜子宫肌瘤剔除术治疗多发性子宫肌瘤的疗效和可行性。
2006 年 1 月至 2011 年 3 月，我们中心对 565 例有症状的子宫肌瘤患者进行了手指辅助腹腔镜子宫肌瘤剔除术，以切除多发性子宫肌瘤。腹腔镜子宫肌瘤剔除术技术进行了改良，包括将两根手指插入阴道以提起子宫，同时另一只手的一根或两根手指通过耻骨上 15mm 的 trocar 端口插入腹部，用于触诊小的子宫肌瘤，这不会扭曲子宫轮廓。
患者的平均（标准差；范围）年龄为 38.26 岁（5.84；25-48 岁）。每个病例中最大子宫肌瘤的直径为 6.13cm（1.21；4-15cm）。初次剔除的子宫肌瘤总数为 2228 个。有 597 个额外的子宫肌瘤在手指辅助引导下被剔除。额外剔除的子宫肌瘤的平均直径为 1.1cm（范围，0.2-2.5cm），明显小于初次剔除的子宫肌瘤（p=0.002）。平均手术时间为 97.1 分钟（30.2；35-180 分钟）。术后血红蛋白浓度下降 1.6g/dL（0.7；0.4-3.2g/dL）。手术过程中，没有患者需要输血。有 6 名患者术后发热。没有发生肠或泌尿道损伤。术后平均住院时间为 3.2 天（0.9；2-6d）。所有手术均无需剖腹完成。
手指辅助腹腔镜子宫肌瘤剔除术是治疗多发性子宫肌瘤的一种可行且安全的方法。
