Natural ART Clinic Nihonbashi, Tokyo, Japan.
Fertil Steril. 2018 Mar;109(3):406-417. doi: 10.1016/j.fertnstert.2018.01.032.
The appropriate surgical treatment of adenomyosis, a benign invasion/infiltration of endometrial glands within the underlying myometrium, remains a subject of discussion. Since 1990, in place of the classical V-shaped resection method, various kinds of surgical management have been attempted, including a uterine muscle flap method that emphasizes fertility preservation, an asymmetric dissection method, and various modified reduction methods. Laparoscopic adenomyomectomy has also become an alternative to laparotomy for surgically managing the focal type of adenomyosis, although it seems to be associated with a higher risk of uterine rupture than laparotomy. This article reviews the surgical treatment of adenomyosis, including 23 uterine rupture cases that occurred during post-adenomyomectomy pregnancies, and provides an updated picture of the state of the field.
子宫腺肌病是一种良性的子宫内膜腺体浸润/侵袭到子宫基层的疾病，其适当的手术治疗仍然存在争议。自 1990 年以来，已经尝试了各种手术治疗方法，取代了传统的 V 形切除术，包括强调生育保存的子宫肌瓣法、非对称解剖法和各种改良的切除术。腹腔镜下子宫腺肌瘤切除术也已成为手术治疗局灶型子宫腺肌病的一种替代方法，尽管它似乎比剖腹手术有更高的子宫破裂风险。本文回顾了子宫腺肌病的手术治疗，包括 23 例在子宫腺肌瘤切除术后妊娠期间发生的子宫破裂病例，为该领域的现状提供了最新的信息。
