Trivedi Prakash H, Trivedi Soumil, Patil Sandeep
Aakar IVF-ICSI Centre, Dr. Trivedi's Total Health Care Pvt. Ltd., 1, 2, 3 Gautam Building, Tilak Road, Opp Balaji Temple, Ghatkopar East, Mumbai, 400077 India.
Department of Obstetrics and Gynecology, Rajawadi Hospital, Mumbai, India.
J Obstet Gynaecol India. 2020 Feb;70(1):69-77. doi: 10.1007/s13224-019-01273-9. Epub 2019 Dec 9.
To evaluate contained bag electromechanical morcellation for removal of myomas and uterus with myomas, laparoscopically (Study group B), and compare it with uncontained laparoscopic morcellation (Control group A) in patients with similar parameters done earlier.
Retrospective Cohort Comparative Study (Canadian Task Force 2-1).
Advanced Gynaecologic MAS, university recognized tertiary centre, Mumbai, India.
720 women had laparoscopic removal of myomas or large uterus with myomas during a study period of 6 years (from 13 May 2012 to 14 August 2018) with contained bag electromechanical or conventional morcellation.
Laparoscopic hysterectomy, laparoscopic myomectomy, conventional uncontained morcellation, contained in-bag morcellation.
Laparoscopic contained in-bag morcellation was compared with conventional morcellation of myomas and uterus with large myomas during a study period of 6 years. Parameters assessed were operating time, time for insertion of bag, morcellation of tissues and removal of bag, blood loss, complications, conversion to open surgery and histopathologic findings of tissues. In Group A, in the first 3 years, 355 women underwent uncontained morcellation. Myoma size and weight varied from 5 cm to 26 cm and 200 g to 3740 g respectively. The myoma number ranged from 1 to 18. No case of leiomyosarcoma was reported. In Group B, in the next 3 years, 365 women underwent contained bag morcellation in 196 myomectomy cases and 169 hysterectomy cases. Myoma size and weight varied from 4 cm to 20 cm and 200 g to 2100 g respectively. The number of myomas varied from 1 to 17.
Laparoscopic contained bag morcellation for myomas and uterus with large myomas were evaluated. In myomectomy group both conventional and in bag laparoscopic morcellation were comparable in terms of duration of the surgery and blood loss. When all cases ( hysterectomy and myomectomy combined together) and cases of hysterectomy with large fibroid were studied, laparoscopic in bag morcellation took less operative time and there was statistically significant difference in operative time . No case of leiomyosarcoma was found in our study of 720 cases of myomas or uterus with large myomas.
评估腹腔镜下使用内置袋式电动粉碎术切除肌瘤及合并肌瘤的子宫（研究组B），并与早期进行的参数相似的患者中未使用内置袋的腹腔镜粉碎术（对照组A）进行比较。
回顾性队列比较研究（加拿大工作组2-1）。
印度孟买大学认可的三级高级妇科医学中心。
在6年研究期间（从2012年5月13日至2018年8月14日），720名女性接受了腹腔镜下切除肌瘤或合并肌瘤的大子宫手术，采用内置袋式电动粉碎术或传统粉碎术。
腹腔镜子宫切除术、腹腔镜肌瘤切除术、传统无内置袋粉碎术、内置袋粉碎术。
在6年研究期间，将腹腔镜内置袋粉碎术与肌瘤及合并大肌瘤的子宫的传统粉碎术进行比较。评估的参数包括手术时间、置入袋子的时间、组织粉碎和取出袋子的时间、失血量、并发症、转为开腹手术以及组织的组织病理学检查结果。在A组，前3年，355名女性接受了无内置袋粉碎术。肌瘤大小和重量分别从5厘米至26厘米和200克至3740克不等。肌瘤数量从1至18个不等。未报告平滑肌肉瘤病例。在B组，后3年，365名女性在196例肌瘤切除病例和169例子宫切除病例中接受了内置袋粉碎术。肌瘤大小和重量分别从4厘米至20厘米和200克至2100克不等。肌瘤数量从1至17个不等。
对腹腔镜下肌瘤及合并大肌瘤的子宫的内置袋粉碎术进行了评估。在肌瘤切除组中，传统腹腔镜粉碎术和内置袋腹腔镜粉碎术在手术持续时间和失血量方面相当。当研究所有病例（子宫切除术和肌瘤切除术合并在一起）以及合并大肌瘤的子宫切除病例时，腹腔镜内置袋粉碎术的手术时间较短，且手术时间存在统计学显著差异。在我们对720例肌瘤或合并大肌瘤的子宫的研究中，未发现平滑肌肉瘤病例。
