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腹腔镜子宫肌瘤切除术

Laparoscopic myomectomy.

作者信息

Stoica R A, Bistriceanu I, Sima R, Iordache N

机构信息

General Surgery Department, "Sf. Ioan" Clinical Emergency Hospital, Bucharest, Romania.

Endocrinology Department, Emergency Hospital Craiova, Craiova, Romania.

出版信息

J Med Life. 2014 Oct-Dec;7(4):522-4.

Abstract

Uterine leiomyoma is the most common benign tumour occurring in women in the reproductive age. It is typically found during the middle and later reproductive years. The prevalence quoted in literature ranges from 20-50% based on post mortem studies. The symptoms usually reported by women with fibroids are the following: abnormal gynaecologic haemorrhage, chronic pelvic pain, dyspareunia, as well as urinary and bowel symptoms, urinary frequency or retention and, in some cases, infertility. During pregnancy, premature labor might be caused, interfering with the position of the fetus or abortion could be induced. However, only 30% of the women develop symptoms, most of them being asymptomatic. It was proved that the factors that can cause fibroids are the following: genetic, hormonal, and growth factors, especially transforming the growth factor beta (TGFb)-related cellular changes. As diagnosis tools, studies are revealing that ultrasound has been shown to be an insufficient method of myoma mapping, and magnetic resonance imaging should be preferred for surgical therapy planning. The contour of the endometrial cavity is delineated by using trans vaginal ultrasound and saline infusion hysterosonography, but hysteroscopy is the gold standard to evaluate the uterine cavity.

摘要

子宫平滑肌瘤是育龄期女性最常见的良性肿瘤。它通常在生殖年龄的中后期被发现。根据尸检研究,文献中引用的患病率在20%至50%之间。患有子宫肌瘤的女性通常报告的症状如下:妇科异常出血、慢性盆腔疼痛、性交困难,以及泌尿系统和肠道症状、尿频或尿潴留,在某些情况下还有不孕。在怀孕期间,可能会引起早产,干扰胎儿位置或导致流产。然而,只有30%的女性会出现症状,大多数人没有症状。事实证明,可导致肌瘤的因素如下:遗传、激素和生长因子,尤其是与转化生长因子β(TGFb)相关的细胞变化。作为诊断工具,研究表明超声已被证明是一种不足的肌瘤定位方法,而磁共振成像在手术治疗规划中应更受青睐。通过经阴道超声和盐水灌注子宫超声造影可以勾勒出子宫内膜腔的轮廓,但宫腔镜检查是评估子宫腔的金标准。

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本文引用的文献

3
Predictors of leiomyoma recurrence after laparoscopic myomectomy.腹腔镜子宫肌瘤切除术后肌瘤复发的预测因素
J Minim Invasive Gynecol. 2007 Nov-Dec;14(6):690-7. doi: 10.1016/j.jmig.2007.06.003.
4
Etiology, symptomatology, and diagnosis of uterine myomas.子宫肌瘤的病因、症状学及诊断
Fertil Steril. 2007 Apr;87(4):725-36. doi: 10.1016/j.fertnstert.2007.01.093.
5
[Laparoscopic myomectomy: indications and limits].
Ceska Gynekol. 2007 Jan;72(1):64-8.
6
Fibroids and in-vitro fertilization: which comes first?子宫肌瘤与体外受精:何者为先?
Curr Opin Obstet Gynecol. 2005 Jun;17(3):225-31. doi: 10.1097/01.gco.0000169097.52848.ee.

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