Department of Gynecology, Beijing Obstetrics and Gynecology Hospital (BOGH), Capital Medical University, Beijing 100026, China.
Department of Ultrasonic Medicine, Beijing Obstetrics and Gynecology Hospital (BOGH), Capital Medical University, Beijing 100026, China.
Clin Chim Acta. 2019 Aug;495:652-655. doi: 10.1016/j.cca.2018.05.024. Epub 2018 May 25.
To investigate if intraoperative ultrasounds by laparoscopic and transvaginal ultrasonography (LUS and TVS) could improve enucleating the residual fibroids following laparoscopic myomectomy (LM).
From March to December 2016, 78 women with uterine fibroids underwent LM, LUS and TVS were applied to detect residual fibroids and to guide surgeons to enucleate them after the visible fibroids were removed during LM operation.
The total number of residual fibroids found by LUS was 140, and the total number found by TVS was 127 following LM (P = 0.03). LUS is statistically superior to TVS in the detection of residual fibroids in the anterior wall (P = 0.004), in the detection of intramural fibroids (P = 0.002), and in the detection of fibroids with a diameter ranging from 0.5 to 1 cm (P = 0.002). According to the total number of enucleated fibroids by LM, patients were divided into three groups (Group 1: 2 to 4, Group 2: 5 to 7 and Group 3: ≥8 fibroid counts). The percentages of patients in each group with residual fibroids at the end of surgery were 22.2%, 51.9% and 66.7% respectively.
Both LUS and TVS are beneficial to surgical treatment of fibroids by assisting enucleation of residual fibroids following LM, while LUS is more effective in localizing residual fibroids than TVS.
探讨腹腔镜超声（LUS）和经阴道超声（TVS）术中超声检查是否能改善腹腔镜子宫肌瘤剔除术（LM）后子宫肌瘤的剔除效果。
2016 年 3 月至 12 月，78 例子宫肌瘤患者接受 LM 治疗，LM 术中应用 LUS 和 TVS 检测残留肌瘤，并指导术者切除可见肌瘤后剔除残留肌瘤。
LM 后 LUS 发现的残留肌瘤总数为 140 个，TVS 发现的残留肌瘤总数为 127 个（P=0.03）。LUS 在检测前壁残留肌瘤（P=0.004）、肌壁间肌瘤（P=0.002）和直径 0.5-1cm 肌瘤（P=0.002）方面明显优于 TVS。根据 LM 剔除的肌瘤总数，将患者分为三组（Group 1：2-4 个肌瘤，Group 2：5-7 个肌瘤，Group 3：≥8 个肌瘤）。每组术后残留肌瘤的患者比例分别为 22.2%、51.9%和 66.7%。
LUS 和 TVS 均有助于 LM 后辅助剔除残留肌瘤，改善子宫肌瘤的手术治疗效果，而 LUS 比 TVS 更能有效定位残留肌瘤。
