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腹腔镜或宫腔镜手术治疗Ⅱ型黏膜下肌瘤的临床疗效及术后生活质量比较。

Comparison of clinical outcomes and postoperative quality of life after surgical treatment of type II submucous myoma via laparoscopy or hysteroscopy.

作者信息

Zhang Rui-Chun, Wu Wei, Zou Qing, Zhao Hongmei

机构信息

Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, P. R. China.

Department of Wound Treatment, The First Affiliated Hospital of Harbin Medical University, Harbin, P. R. China.

出版信息

J Int Med Res. 2019 Sep;47(9):4126-4133. doi: 10.1177/0300060519858027. Epub 2019 Jul 7.

Abstract

OBJECTIVE

This study was performed to compare the clinical outcomes, advantages, and disadvantages of laparoscopic myomectomy (LM) and transcervical resection of myoma (TCRM) in the treatment of type II submucous myoma.

METHODS

In total, 136 patients with type II submucous myoma with a tumour diameter of 4 to 5 cm were randomly assigned to the hysteroscopy group or laparoscopy group.

RESULTS

The operative duration was shorter and the intraoperative bleeding volume was lower in the hysteroscopy than laparoscopy group. The success rate of the single-stage operation was obviously higher in the laparoscopy than hysteroscopy group. The duration of postoperative antibiotic use and the length of hospital stay were shorter in the hysteroscopy than laparoscopy group. The time to complete healing of the muscle layer was shorter in the hysteroscopy than laparoscopy group. The rate of intraoperative complications was lower in the hysteroscopy than laparoscopy group.

CONCLUSION

Both hysteroscopic and laparoscopic surgery have beneficial effects in the treatment of type II submucous myoma. Hysteroscopic surgery has the advantages of a short operative duration, low intraoperative bleeding volume, fast postoperative recovery, and high quality of life. Laparoscopic surgery involves many intraoperative complications and slow recovery of ovarian function.

摘要

目的

本研究旨在比较腹腔镜子宫肌瘤切除术(LM)和经宫颈肌瘤切除术(TCRM)治疗Ⅱ型黏膜下肌瘤的临床疗效、优缺点。

方法

总共136例肿瘤直径为4至5厘米的Ⅱ型黏膜下肌瘤患者被随机分配至宫腔镜组或腹腔镜组。

结果

宫腔镜组的手术时间比腹腔镜组短,术中出血量比腹腔镜组少。腹腔镜组的一期手术成功率明显高于宫腔镜组。宫腔镜组术后抗生素使用时间和住院时间比腹腔镜组短。宫腔镜组肌层完全愈合时间比腹腔镜组短。宫腔镜组术中并发症发生率比腹腔镜组低。

结论

宫腔镜手术和腹腔镜手术在治疗Ⅱ型黏膜下肌瘤方面均有有益效果。宫腔镜手术具有手术时间短、术中出血量少、术后恢复快和生活质量高的优点。腹腔镜手术涉及许多术中并发症且卵巢功能恢复缓慢。

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Uterine myomata: Organ-preserving surgery.子宫肌瘤:保留器官手术。
Best Pract Res Clin Obstet Gynaecol. 2016 Aug;35:30-6. doi: 10.1016/j.bpobgyn.2015.09.005. Epub 2015 Oct 19.

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