Mecke H, Wallas F, Bröcker A, Gertz H P
Geburtshilflich-gynäkologische Abteilung Auguste-Viktoria-Krankenhaus Berlin.
Geburtshilfe Frauenheilkd. 1995 Jul;55(7):374-9. doi: 10.1055/s-2007-1022804.
Between 1992 and 1993 surgery conserving the organ was undertaken in 215 patients with uterine myomas. Only myomas of more than 2 cm in diameter were included. It was possible to conserve the organ in 207 cases (90%). Myomectomy by pelviscopy was performed in 131 cases. The procedure was successful in 117 cases (89%), secondary laparotomy had to be done in 14 of these patients. On average the myomas removed by pelviscopy measured 5.2 cm in diameter. The S.E.M.M. (Serrated Edged Macro Morcellator) was used in the procedure. It did not take long to morecellate even larger myomas (the largest one removed by pelviscopy weighed 418 g) and to remove them by means of a 15 mm-trocar. An average of 2 myomas were removed per patient (r: 1-5). The mean Hb drop amounted to 1.5 g%. Repeat pelviscopy had to be done in one patient because of a secondary haemorrhage, a laparotomy and hysterectomy for subilius had to be performed in one case on the 3rd postoperative day. An intestinal loop has adhered to the uterine wound dehiscence. No other complications were observed after pelviscopic myomectomy. A 41-year-old patient wanting children suffered a late complication, namely a ruptured uterus in the 28 w of pregnancy. It is therefore imperative to inform patients who are still in the reproductive phase about the possibility of an uterus rupture after pelviscopic myomectomy.
1992年至1993年间，对215例子宫肌瘤患者实施了保留器官的手术。仅纳入直径超过2厘米的肌瘤。207例（90%）成功保留了器官。131例行腹腔镜子宫肌瘤切除术。该手术117例（89%）成功，其中14例患者需行二次剖腹手术。腹腔镜切除的肌瘤平均直径为5.2厘米。手术中使用了锯齿边缘大型切碎器（S.E.M.M.）。切碎甚至更大的肌瘤（腹腔镜切除的最大肌瘤重418克）并通过15毫米套管针取出并不耗时。每位患者平均切除2个肌瘤（范围：1 - 5个）。血红蛋白平均下降1.5 g%。1例患者因继发性出血需再次行腹腔镜检查，1例在术后第3天因子宫下段裂开行剖腹手术及子宫切除术。一例肠袢粘连于子宫伤口裂开处。腹腔镜子宫肌瘤切除术后未观察到其他并发症。一名41岁想要孩子的患者出现晚期并发症，即在妊娠28周时子宫破裂。因此，必须告知仍处于生育期的患者腹腔镜子宫肌瘤切除术后子宫破裂的可能性。
