Davis G D
Obstet Gynecol. 1986 Sep;68(3):422-5. doi: 10.1097/00006250-198609000-00028.
One hundred fifty-eight patients with endometriosis were treated with the carbon dioxide laser laparoscope and followed for 15 months. The revised American Fertility Society classification of endometriosis was used to stage the disease. The median revised American Fertility Society points per patient was 29.4. Removal of adhesions, periureteral endometriosis, and superficial bowel endometriosis was accomplished. Complications consisted of bleeding, extravasation of fluid, and uterine and bladder puncture. No serious complications requiring laparotomy were encountered. Significant relief of dysmenorrhea and dyspareunia as well as enhanced fertility was achieved. Second-look laparoscopy confirmed efficient removal of endometriosis. Pain relief and pregnancy data are presented. Endometriosis and its related adhesions can be removed precisely and relatively bloodlessly with the carbon dioxide laser laparoscope. Expertise in advanced laparoscopy and a thorough knowledge of use of the carbon dioxide laser and its bioeffects are prerequisites to performing this procedure.
158例子宫内膜异位症患者接受了二氧化碳激光腹腔镜治疗，并随访15个月。采用美国生殖医学协会修订的子宫内膜异位症分类法对疾病进行分期。每位患者的美国生殖医学协会修订评分中位数为29.4分。完成了粘连、输尿管周围子宫内膜异位症和浅表性肠子宫内膜异位症的切除。并发症包括出血、液体外渗以及子宫和膀胱穿孔。未遇到需要剖腹手术的严重并发症。痛经和性交困难得到显著缓解，生育能力增强。二次腹腔镜检查证实子宫内膜异位症已有效切除。给出了疼痛缓解和妊娠数据。二氧化碳激光腹腔镜可以精确且相对无血地切除子宫内膜异位症及其相关粘连。先进腹腔镜技术的专业知识以及对二氧化碳激光的使用及其生物效应的透彻了解是实施该手术的先决条件。
