卵巢良性肿瘤宫腔镜辅助经阴道手术与腹腔镜手术的比较  

Comparison between Hysteroscopic-assisted Transvaginal Approach and Laparoscopic Surgery for Benign Ovarian Tumors

作　　者：刘仙[1] 宋岩峰[2] 赵锐[1] 宣毅飞[1] 肖金辉[1] 刘冬萍[1] 

机构地区：[1]中国人民解放军184医院妇产科,鹰潭335000 [2]南京军区福州总医院妇产科,福州350000

出　　处：《中国微创外科杂志》2012年第4期325-327,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：南京军区科研课题;编号:08MA065

摘　　要：目的探讨宫腔镜辅助经阴道切除卵巢良性肿瘤的可行性。方法 2010年3月～2011年10月我院65例需要保留子宫的直径<10 cm卵巢良性肿瘤,其中28例采用经阴道切开后穹隆,撑开器暴露子宫直肠陷凹,联合宫腔镜行卵巢肿瘤切除术(研究组),37例行腹腔镜手术(对照组)。比较2种手术方式的术中出血量、手术时间、术后疼痛、术后病率、肠功能恢复时间、术后住院时间、住院费用。结果研究组手术时间(40.1±4.5)min显著短于对照组(60.2±6.0)min(t=-14.837,P=0.000),术后肠功能恢复时间(13.4±8.5)h显著短于对照组(23.5±9.5)h(t=-4.351,P=0.000),术后疼痛明显轻于对照组(Z=-8.525,P=0.002),住院费用(4231.2±103.2)元明显低于对照组(5442.7±123.2)元(t=-42.038,P=0.000);研究组术后病率与对照组无统计学差异(0例vs.5例,P=0.053),术中出血量(55.2±5.2)ml与对照组(53.2±5.8)ml差异无显著性(t=1.439,P=0.155),术后住院时间(4.5±1.5)d与对照组(5.0±1.5)d差异无显著性(t=1.331,P=0.188)。结论宫腔镜辅助经阴道切除卵巢良性肿瘤可行,具有创伤小、恢复快、腹部无瘢痕、无须气腹、标本完整取出等优点,但要选择适当的病例。Objective To study the feasibility of hysteroscopic-assisted transvaginal approach for benign ovarian tumors.Methods From March 2010 to October 2011,65 patients with benign ovarian tumor（ 10 cm in diameter） received treatment with conservation of the uterus in our hospital.Transvaginal approach combined with hysteroscopy（study group） was performed on 28 of the patients;the other 37 patients received laparoscopic surgery（control group）.The intraoperative blood loss,operation time,postoperative pain,morbidity,gastrointestinal recovery time,and hospital stay,as well as hospital cost were compared between the two groups.Results The study group showed significantly shorter operation time and gastrointestinal recovery time,less postoperative pain,and lower hospital cost [（40.1±4.5） min vs.（60.2±6.0） min,t=-14.837,P=0.000;（13.4±8.5） hours vs.（23.5±9.5） hours,t=-4.351,P=0.000;Z=-8.525,P=0.002;（4231.2±103.2） RMB vs.（5442.7±123.2） RMB,t=-42.038,P=0.000].No significant difference existed between the two groups in the postoperative morbidity,intraoperative blood loss,and postoperative hospital stay [（0 vs.5,P=0.053;（55.2±5.2） ml vs.（53.2±5.8） ml,t=1.439,P=0.155;（4.5±1.5） d vs.（5.0±1.5） d,t=1.331,P=0.188].Conclusions Transvaginal approach combined hysteroscopic operation is feasible and minimally invasive for benign ovarian tumor.However,strict indications are required for the operation.With the procedure,we may perform non-pneumoperitoneum surgery and remove the specimen completely without making any abdominal incision.Patients recover quickly after the operation.

关 键 词：卵巢良性肿瘤 经阴道 宫腔镜 腹腔镜 

分 类 号：R737.31[医药卫生—肿瘤]