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宫腔镜与腹腔镜下子宫肌瘤切除术治疗Ⅱ型黏膜下肌瘤的适应症及疗效

The indication and curative effect of hysteroscopic and laparoscopic myomectomy for type II submucous myomas.

作者信息

Wang Haibo, Zhao Jinrong, Li Xiujuan, Li Ping, Lu Caihong, Tian Shujuan, Wang Zhong-hua

机构信息

Department of Obstetrics and Gynaecology, The 260th Hospital of PLA, No. 346 Shengli North Street, Shijiazhuang, 050041, China.

出版信息

BMC Surg. 2016 Feb 27;16:9. doi: 10.1186/s12893-016-0124-7.

Abstract

BACKGROUND

The aim of this study was to assess curative effect of hysteroscopic and laparoscopic myomectomy for type II submucous myomas between 3 and 5 cm in diameter and explore the optimal surgical indications.

METHODS

A retrospective analysis was performed of those who underwent hysteroscopic or laparoscopic myomectomy from January 2008 to January 2013. The patients were divided into three subgroups according to the myomas diameter (namely, 30 mm ≤ myomas diameter <40 mm; 40 mm ≤ myomas diameter <50 mm; and myomas diameter ≥ 50 mm). Clinical data such as operation time, amount of bleeding, postoperative anal exsufflation time, hospital stay, and complications were collected.

RESULTS

There was no significant difference regarding operation time and amount of bleeding in two groups. We found significant difference in hysteroscopic group (within-subgroup) difference regarding operation time and amount of bleeding, whereas no significant difference in the laparoscopic group, while significant differences between-subgroup differences regarding operation time. Complete removal of myoma was seen in all patients.

CONCLUSIONS

Both techniques are feasible for type II submucous myomas. Laparoscopic operation has higher advantages in type II submucous myomas of greater than 4 cm in diameter whereas hysteroscopic operation has higher advantages in type II submucous myomas of lower than 4 cm in diameter.

摘要

背景

本研究旨在评估宫腔镜和腹腔镜子宫肌瘤切除术治疗直径3至5厘米的II型黏膜下肌瘤的疗效,并探讨最佳手术指征。

方法

对2008年1月至2013年1月期间接受宫腔镜或腹腔镜子宫肌瘤切除术的患者进行回顾性分析。根据肌瘤直径将患者分为三个亚组(即30毫米≤肌瘤直径<40毫米;40毫米≤肌瘤直径<50毫米;肌瘤直径≥50毫米)。收集手术时间、出血量、术后肛门排气时间、住院时间和并发症等临床资料。

结果

两组在手术时间和出血量方面无显著差异。我们发现宫腔镜组(亚组内)在手术时间和出血量方面存在显著差异,而腹腔镜组无显著差异,亚组间手术时间存在显著差异。所有患者的肌瘤均被完全切除。

结论

两种技术对II型黏膜下肌瘤均可行。腹腔镜手术在直径大于4厘米的II型黏膜下肌瘤中具有更高优势,而宫腔镜手术在直径小于4厘米的II型黏膜下肌瘤中具有更高优势。

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