Faguer C, Vaillant F, Maghioracos P, Fai R
Sem Hop. 1983 May 12;59(19):1445-8.
Seventy cases of myomectomy performed over 5 years (1977 to 1982) in the department of Gynecology & Obstetrics of the St Antoine Hospital in Paris are analyzed. During the same period, 465 patients underwent hysterectomy for leiomyoma. A brief review shows that myomectomy is not the best surgical treatment of uterine leiomyoma because of its complications. Hemorrhagy, pelvic pain and infertility remain the principle modes of discovery of uterine leiomyoma in operated patients, whose median age is fairly low. Hysterosalpingography is still the main procedure for the investigation and diagnosis of leiomyoma. However, indications of echotomography have been extended with an increase in the frequency of diagnosis of leiomyoma due to a better semiology. Primary leiomyoma section followed by excision appears preferable to conventional enucleation, which is frequently hemorrhagic and blind. In determining the indications of myomectomy, certain factors must be borne in mind: age, parity, type and insertion of leiomyoma, gynecologic history and psychological status. Good postoperative results explain the recent favor of myomectomy as the conservative surgical treatment of leiomyoma; surgical abstention, however, remains the best decision in most cases.
对巴黎圣安托万医院妇产科在5年期间（1977年至1982年）实施的70例子宫肌瘤切除术进行了分析。同期，465例患者因子宫肌瘤接受了子宫切除术。简要回顾表明，由于子宫肌瘤切除术存在并发症，它并非子宫平滑肌瘤的最佳手术治疗方法。出血、盆腔疼痛和不孕仍是接受手术患者中子宫平滑肌瘤的主要发现方式，这些患者的中位年龄相当低。子宫输卵管造影术仍是子宫肌瘤检查和诊断的主要方法。然而，随着因更好的影像学表现而使子宫肌瘤诊断频率增加，超声断层扫描的应用范围有所扩大。先进行子宫肌瘤切开再切除似乎比传统的肌瘤剜除术更可取，传统肌瘤剜除术常常出血且盲目。在确定子宫肌瘤切除术的适应证时，必须考虑某些因素：年龄、产次、肌瘤的类型和附着部位、妇科病史及心理状态。良好的术后效果解释了近期子宫肌瘤切除术作为平滑肌瘤保守性手术治疗方法受到青睐的原因；然而，在大多数情况下，不进行手术仍是最佳决策。
