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Risk of morcellation of uterine leiomyosarcomas in laparoscopic supracervical hysterectomy and laparoscopic myomectomy, a retrospective trial including 4791 women.腹腔镜次全子宫切除术和腹腔镜子宫肌瘤剔除术中子宫平滑肌肉瘤粉碎术的风险:一项纳入4791名女性的回顾性试验
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Laparoscopic myomectomy - The importance of surgical techniques.腹腔镜子宫肌瘤切除术——手术技术的重要性。
Front Med (Lausanne). 2023 Mar 20;10:1158264. doi: 10.3389/fmed.2023.1158264. eCollection 2023.

本文引用的文献

1
Uterine rupture at 28 weeks of gestation after laparoscopic myomectomy - a case report.腹腔镜子宫肌瘤切除术后妊娠28周子宫破裂——一例报告
Prz Menopauzalny. 2018 Jun;17(2):101-104. doi: 10.5114/pm.2018.77314. Epub 2018 Jun 30.
2
Characteristics of uterine rupture after laparoscopic surgery of the uterus: clinical analysis of 10 cases and literature review.子宫腹腔镜手术后子宫破裂的特征:10例临床分析及文献复习
J Int Med Res. 2018 Sep;46(9):3630-3639. doi: 10.1177/0300060518776769. Epub 2018 Jun 19.
3
Laparoscopic uterine surgery as a risk factor for uterine rupture during pregnancy.腹腔镜子宫手术增加妊娠子宫破裂的风险。
PLoS One. 2018 May 22;13(5):e0197307. doi: 10.1371/journal.pone.0197307. eCollection 2018.
4
Current medical treatment of uterine fibroids.子宫肌瘤的当前医学治疗方法。
Obstet Gynecol Sci. 2018 Mar;61(2):192-201. doi: 10.5468/ogs.2018.61.2.192. Epub 2018 Feb 13.
5
The current place of medical therapy in uterine fibroid management.医学疗法在子宫肌瘤管理中的当前位置。
Best Pract Res Clin Obstet Gynaecol. 2018 Jan;46:57-65. doi: 10.1016/j.bpobgyn.2017.10.008. Epub 2017 Oct 22.
6
Laparoscopic myomectomy and morcellation: A review of techniques, outcomes, and practice guidelines.腹腔镜子宫肌瘤剔除术和粉碎术:技术、结果和实践指南综述。
Best Pract Res Clin Obstet Gynaecol. 2018 Jan;46:99-112. doi: 10.1016/j.bpobgyn.2017.09.012. Epub 2017 Sep 29.
7
Medical therapy for fibroids: An overview.子宫肌瘤的医学治疗:概述。
Best Pract Res Clin Obstet Gynaecol. 2018 Jan;46:48-56. doi: 10.1016/j.bpobgyn.2017.09.007. Epub 2017 Sep 28.
8
Epidemiology and Risk Factors of Uterine Fibroids.子宫肌瘤的流行病学和危险因素。
Best Pract Res Clin Obstet Gynaecol. 2018 Jan;46:3-11. doi: 10.1016/j.bpobgyn.2017.09.004. Epub 2017 Oct 1.
9
Uterine fibroid management: from the present to the future.子宫肌瘤的管理:从现在到未来。
Hum Reprod Update. 2016 Nov;22(6):665-686. doi: 10.1093/humupd/dmw023. Epub 2016 Jul 27.
10
Robotic assisted vs laparoscopic and/or open myomectomy: systematic review and meta-analysis of the clinical evidence.机器人辅助与腹腔镜和/或开放性子宫肌瘤切除术:临床证据的系统评价和荟萃分析
Arch Gynecol Obstet. 2016 Jul;294(1):5-17. doi: 10.1007/s00404-016-4061-6. Epub 2016 Mar 11.

腹腔镜子宫肌瘤剔除术后妊娠结局分析:一项回顾性队列研究。

Analysis of Pregnancy Outcomes after Laparoscopic Myomectomy: A Retrospective Cohort Study.

机构信息

Department of Obstetrics and Gynecology, Ningbo Women and Children's Hospital in Zhejiang Province, China.

出版信息

Comput Math Methods Med. 2022 May 14;2022:9685585. doi: 10.1155/2022/9685585. eCollection 2022.

DOI:10.1155/2022/9685585
PMID:35607646
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9124068/
Abstract

OBJECTIVE

This study aimed to investigate the factors related to pregnancy outcomes after laparoscopic myomectomy.

METHODS

A retrospective review was conducted on 156 patients aged 18 to 45 years who underwent laparoscopic myomectomy in Ningbo Women and Children's Hospital from January 2010 to December 2016. Follow-up medical records and information were collected on demographic variables, clinical variables, and postoperative pregnancy rate. The logistic regression model was used to assess the association between related factors and postoperative pregnancy rate or pregnancy outcome. The outcome indicators included abortion = 0, premature birth = 1, and full term = 2. The chi-squared test or Fisher's exact test was used to compare the differences in pregnancy outcomes, postpartum hemorrhage, and placenta adhesion between the cohorts.

RESULTS

The size of fibroids correlated with the postoperative pregnancy rate. The larger the fibroids, the lower the postoperative pregnancy rate, and the difference was statistically significant. The number of fibroids and placental adhesions was positively associated with postoperative pregnancy; the higher the number of fibroids, the higher the incidence of placental adhesions. However, the postoperative interval of pregnancy, fibroid size, and number and type of fibroids are not correlated with the pregnancy outcomes of postoperative patients.

CONCLUSIONS

The size of myoma may influence the pregnancy rate of patients after laparoscopic myomectomy. The number of fibroids can affect the incidence of placental adhesions during postoperative pregnancy.

摘要

目的

本研究旨在探讨腹腔镜子宫肌瘤剔除术后妊娠结局的相关因素。

方法

回顾性分析 2010 年 1 月至 2016 年 12 月在宁波市妇女儿童医院行腹腔镜子宫肌瘤剔除术的 156 例 18 至 45 岁患者的临床资料。收集患者的人口统计学变量、临床变量及术后妊娠率等随访资料,采用 logistic 回归模型评估相关因素与术后妊娠率及妊娠结局的关系。结局指标包括流产=0、早产=1、足月=2。采用卡方检验或 Fisher 确切概率法比较两组患者妊娠结局、产后出血及胎盘粘连的差异。

结果

肌瘤大小与术后妊娠率相关,肌瘤越大,术后妊娠率越低,差异有统计学意义。肌瘤数目和胎盘粘连与术后妊娠呈正相关,肌瘤数目越多,胎盘粘连发生率越高。然而,术后妊娠间隔、肌瘤大小、肌瘤数目和类型与术后患者的妊娠结局无关。

结论

子宫肌瘤的大小可能影响腹腔镜子宫肌瘤剔除术后患者的妊娠率,肌瘤数目可影响术后妊娠时胎盘粘连的发生率。