Kim Hyunkyung, Shim Suhyun, Hwang Youngbin, Kim Minkyoung, Hwang Hyejin, Chung Younjee, Cho Hyun-Hee, Kim Mee-Ran
Seoul St. Mary's Fibroid Center, Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Obstet Gynecol Sci. 2018 Jan;61(1):135-141. doi: 10.5468/ogs.2018.61.1.135. Epub 2017 Dec 22.
To evaluate the feasibility of robot-assisted laparoscopic myomectomy in multiple myomas over 10.
A retrospective study was conducted for 662 patients who underwent robot-assisted laparoscopic myomectomy and open myomectomy by a single operator in a tertiary university hospital.
A total of 30 women underwent removal of 10 or more uterine myomas by robotics and 13 patients were selected for this study. The average number of myomas removed was 13.7 (range 10-20). The maximum diameter of the myomas was 6.8 cm (range 5.0-10.0 cm). The sum of the diameters of each myoma was 34.7 cm (range 20.0-54.5 cm) and the mass of resected myomas for each case was 229.1 g (range 106.8-437.9 g). In no case was the robotic procedure converted into conventional laparoscopy or laparotomy, and all patients recovered without any major complications. In comparison with 13 cases of open myomectomy during the same period, robotic surgery took longer time than open surgery (360.5 vs. 183.8 minutes; =0.001) but had shorter postoperative hospital days after surgery (mean 2.5 vs. 3.5 days; =0.003).
Robot-assisted laparoscopic myomectomy could be an alternative to laparotomic myomectomy for numerous myomas over 10 in number.
评估机器人辅助腹腔镜下多发性子宫肌瘤切除术（肌瘤直径超过10cm）的可行性。
对在某三级大学医院由同一手术医生实施机器人辅助腹腔镜子宫肌瘤切除术和开放性子宫肌瘤切除术的662例患者进行回顾性研究。
共有30名女性通过机器人手术切除了10个或更多的子宫肌瘤，本研究选取了其中13例患者。切除肌瘤的平均数量为13.7个（范围为10 - 20个）。肌瘤的最大直径为6.8cm（范围为5.0 - 10.0cm）。每个肌瘤直径之和为34.7cm（范围为20.0 - 54.5cm），每例切除肌瘤的质量为229.1g（范围为106.8 - 437.9g）。无一例机器人手术转为传统腹腔镜手术或开腹手术，所有患者均康复且无任何严重并发症。与同期13例开放性子宫肌瘤切除术相比，机器人手术耗时比开放手术长（360.5分钟对183.8分钟；P = 0.001），但术后住院天数较短（平均2.5天对3.5天；P = 0.003）。
对于数量超过10个的多发性子宫肌瘤，机器人辅助腹腔镜子宫肌瘤切除术可作为开腹子宫肌瘤切除术的替代方法。
