经脐旋削法在腹腔镜子宫肌瘤剔除术中的应用  

Application of transumbilical scalpel morcellation in laparoscopic myomectomy

作　　者：王青元[1] 王静[1] 宋玉荣[1] 王文艳[1] WANG Qing-yuan;WANG Jing;SONG Yu-rong(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院妇产科,安徽合肥230601

出　　处：《腹腔镜外科杂志》2022年第12期933-937,共5页Journal of Laparoscopic Surgery

基　　金：国家自然科学基金青年基金项目(81100412)。

摘　　要：目的:探讨经脐子宫肌瘤袋内旋削法在腹腔镜子宫肌瘤切除术中的有效性及安全性。方法:回顾分析2019年1月至2021年12月206例行腹腔镜子宫肌瘤剔除术患者的临床资料,其中99例经脐孔行子宫肌瘤旋削(观察组),107例使用电动粉碎器取出肌瘤(对照组),比较两组术中、术后情况。结果:206例患者均顺利完成手术。观察组手术时间[105.0(90.0,147.5)min vs.90.0(75.0,120.0)min,P=0.001]、标本取出时间[20.0(17.0,25.0)min vs.16.0(15.0,18.0)min,P<0.001]长于对照组。随着手术医生经验的积累,观察组标本取出时间逐渐缩短。观察组术后通气时间短于对照组[21.0(18.0,26.0)h vs.23.0(19.0,40.0)h,P<0.05],美容评分高于对照组[22.0(21.0,23.0)分vs.21.0(21.0,22.0)分,P<0.01]。两组术后血红蛋白下降幅度、并发症发生率、术后最高体温、术后住院时间、住院费用差异无统计学意义(P>0.05)。患者术后病理均为良性平滑肌瘤。结论:经脐子宫肌瘤袋内旋削法是经济、安全、有效的取瘤方式,可在临床推广应用。Objective:To investigate the efficacy and safety of in-bag transumbilical scalpel morcellation in laparoscopic m yomectomy.Methods:Clinical data of 206 patients who underwent laparoscopic myomectomy from Jan.2019 to Dec.2021 were retrospectively analyzed.99 patients underwent in-bag transumbilical scalpel morcellation(observation group)and 107 patients underwent in-bag power morcellation(control group).The intraoperative and postoperative data were compared between the two groups.Results:All the 206 operations were successful.The operation time of observation group was longer than that of control group[105.0(90.0,147.5)min vs.90.0(75.0,120.0)min,P=0.001]and the specimen removal time was also longer than that of control group[20.0(17.0,25.0)min vs.16.0(15.0,18.0)min,P<0.001].However,with the accumulation of surgeons’experience,the time for specimen removal in the observation group was gradually shortened.The postoperative ventilation time of observation group was shorter than that of control group[21.0(18.0,26.0)h vs.23.0(19.0,40.0)h,P<0.05],and cosmetic score of observation group was higher than that of control group[22.0(21.0,23.0)vs.21.0(21.0,22.0),P<0.01].There were no significant differences in the postoperative hemoglobin drop,incidence of complications,postoperative maximum body temperature,postoperative hospital stay and hospitalization costs between the two groups(P>0.05).The postoperative pathology of all cases were benign leiomyoma.Conclusions:In-bag transumbilical scalpel morcellation appears an economical,safe and effective way for myoma retrieval,and it is expected to be widely used in clinical practice.

关 键 词：子宫肌瘤剔除术 腹腔镜检查 经脐 

分 类 号：R713.4[医药卫生—妇产科学]