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腹腔镜超声刀在子宫腺肌病中的手术疗效。

Surgical Efficacy among Laparoscopic Ultrasonic Dissectors in Adenomyosis.

机构信息

Department of Obstetrics and Gynecology, Jinhua Maternity and Child Health Care Hospital, Jinhua, China,

Department of Obstetrics and Gynecology, Jinhua Maternity and Child Health Care Hospital, Jinhua, China.

出版信息

Gynecol Obstet Invest. 2023;88(3):168-173. doi: 10.1159/000530068. Epub 2023 Mar 20.

DOI:10.1159/000530068
PMID:36940680
Abstract

OBJECTIVES

The present study aimed to investigate the efficacy of ultrasonic dissectors for adenomyomectomy using the double/multiple-flap method combined with temporary occlusion of the temporary bilateral uterine artery and the utero-ovarian vessels for the treatment of symptomatic adenomyosis.

DESIGN

This was a retrospective study.

PARTICIPANTS

In total, 162 patients with symptomatic adenomyosis were included, and all of them had originally been scheduled to group A (n = 82) and group B (n = 80) with each group representing a different surgical application. All eligible women were informed of the potential complications, benefits, and alternatives of each approach before they were assigned to one of the two groups, and patients chose group A or group B by themselves. In group A, we performed laparoscopic ultrasonic dissectors in adenomyosis with the double/multiple-flap method combined with temporary occlusion of the bilateral uterine artery and utero-ovarian vessels, while in group B, we performed adenomyomectomy with scissors. During the period of treatment, we evaluated operative time, intraoperative blood loss, and the degree of fatigue of surgeons' fingers.

RESULTS

The estimated blood loss, operative time, and the degree of fatigue of surgeons' fingers in group A were significantly lower than that in group B (p < 0.001). No serious perioperative complications were observed in either group.

LIMITATIONS

This was a retrospective study.

CONCLUSION

The use of ultrasonic dissectors in laparoscopic adenomyomectomy with temporary occlusion of the bilateral uterine artery and the utero-ovarian vessels leads to improvements and releases the fatigue of surgeons' fingers in laparoscopic adenomyomectomy.

摘要

目的

本研究旨在探讨超声刀联合临时阻断双侧子宫动脉及卵巢固有动脉的双/多瓣法在治疗有症状的子宫腺肌病中的疗效。

设计

这是一项回顾性研究。

参与者

共纳入 162 例有症状的子宫腺肌病患者,所有患者最初均被分为 A 组(n=82)和 B 组(n=80),每组代表不同的手术应用。所有符合条件的患者在被分配到两组之一之前,均被告知每种方法的潜在并发症、益处和替代方案,患者自行选择 A 组或 B 组。在 A 组中,我们使用腹腔镜超声刀行双/多瓣法联合临时阻断双侧子宫动脉和卵巢固有动脉的腺肌病切除术,而在 B 组中,我们使用剪刀行腺肌病切除术。在治疗期间,我们评估了手术时间、术中出血量和术者手指的疲劳程度。

结果

A 组的估计出血量、手术时间和术者手指的疲劳程度明显低于 B 组(p < 0.001)。两组均未观察到严重的围手术期并发症。

局限性

这是一项回顾性研究。

结论

在腹腔镜下腺肌病切除术中联合使用超声刀并临时阻断双侧子宫动脉及卵巢固有动脉,可以改善术者手指的疲劳,提高手术效果。

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