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机器人子宫肌瘤切除术的新手术技术:肌瘤连续锁定缝合(LSOM)技术

New Surgical Technique for Robotic Myomectomy: Continuous Locking Suture on Myoma (LSOM) Technique.

作者信息

Lee Sa Ra, Lee Eun Sil, Eum Hye Lim, Lee Young-Jae, Lee Shin-Wha, Park Jeong Yeol, Suh Dae-Shik, Kim Dae-Yeon, Kim Sung Hoon, Kim Yong-Man, Kim Young-Tak

机构信息

Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Seoul Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.

Department of Obstetrics and Gynecology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea.

出版信息

J Clin Med. 2021 Feb 8;10(4):654. doi: 10.3390/jcm10040654.

Abstract

Robot-assisted laparoscopic myomectomy (RALM) has broadened the indications even in complex myomas. However, the high cost of RALM remains the main disadvantage. Therefore, a surgical technique that can reduce the cost of RALM and still has the advantages of robotic surgery is required. We propose a "locking suture on myoma (LSOM)" technique and compared the operative and perioperative outcomes of patients who underwent RALM with or without the LSOM technique. We included 337 patients who underwent RALM with ( = 160) or without ( = 177) the LSOM technique between March 2019 and August 2020. The LSOM group had low parity and gravidity, with a low rate of Cesarean sections. Myoma type was not different between the groups; however, patients in the LSOM group had larger, heavier, and higher number of myomas, although fewer patients had multiple myomas and were discharged earlier. Total operating time, estimated blood loss, pre- and postoperative hemoglobin levels, transfusion rate, and postoperative fever were not different between the two groups. In conclusion, the LSOM technique may be a viable surgical option for myomas, as it can reduce the cost of RALM by obviating the need for robotic Tenaculum forceps.

摘要

机器人辅助腹腔镜子宫肌瘤切除术(RALM)即使在复杂肌瘤的治疗中也扩大了适应症。然而,RALM的高成本仍然是其主要缺点。因此,需要一种既能降低RALM成本又能保留机器人手术优势的手术技术。我们提出了一种“肌瘤上锁定缝合(LSOM)”技术,并比较了采用或未采用LSOM技术的接受RALM患者的手术及围手术期结果。我们纳入了2019年3月至2020年8月期间接受RALM的337例患者,其中采用LSOM技术的有160例,未采用的有177例。LSOM组的产次和妊娠次数较低,剖宫产率也较低。两组间肌瘤类型无差异;然而,LSOM组的患者肌瘤更大、更重、数量更多,尽管患有多发性肌瘤的患者较少且出院更早。两组间总手术时间、估计失血量、术前和术后血红蛋白水平、输血率及术后发热情况均无差异。总之,LSOM技术可能是治疗肌瘤的一种可行手术选择,因为它无需使用机器人子宫抓钳,从而可降低RALM的成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a123/7914728/8ad3e0b45221/jcm-10-00654-g001.jpg

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