Objective To investigate the safety, feasibility and efficacy of laparoscopic myomectomy. Methods We retrospectively analyzed the clinical data of 97 cases of laparoscopic myomectomy ( laparoscope group) and 90 cases of open myomectomy (open group), that were performed in this hospital from January 2008 to September 2010. The operation time, postoperative drop of hemoglobin ( Hgb) level, analgesic use, hospital stay, medical and hospitalization cost, and postoperative morbidity, complications and rate of myomas incidence of both the groups were compared. Results Compared with the open group, laparoscope group had significantly smaller drop of hemoglobin level [ ( 14. 3 ± 6. 4) g/L vs. ( 17. 4 ± 7. 4) g/L, t = -3. 152, P = 0.002] , less analgesic use [4 cases (4. 1% ) vs. 31 cases (34.4% ) , x2 =28.211, P =0.000] , shorter hospital stay [ (5.0 ±1.3) d vs. (6.9 ± 1.3) d, t = - 10. 106, P =0.000] , but longer operation time [(120.2 ±39.3) min vs. (99. 8 ±36. 8) min, t = 3.646, P=0.000], and higher total medical and hospitalization cost [ (7216. 0 ± 850. 9) RMB vs. (6531. 6 ± 875. 6) RMB, t = 5.419, P= 0.000]. No significant difference exists between the two groups in the rates of postoperative complications and morbidity, 1 -month rate of residual myomas, and 6-month rate of recurrence ( all P > 0. 05 ) . Conclusion Laparoscopic myomectomy is a safe, feasible and minimally invasive approach, but it is not a complete alternative of open surgery.%目的 探讨腹腔镜子宫肌瘤剔除术的安全性、可行性与临床效果. 方法 回顾分析2008年1月～ 2010年9月腹腔镜子宫肌瘤剔除术97例(腹腔镜组)与开腹子宫肌瘤剔除术90例(开腹组)的临床资料.对2组手术时间、术后血红蛋白下降值、镇痛药物使用率、住院时间、住院费用、术后病率、术后并发症、术后复发情况进行比较. 结果 与开腹组相比,腹腔镜组术后血红蛋白下降少[(14.3±6.4)g/L vs.(17.4±7.4) g/L,t=-3.152,P=0.002],使用镇痛药者少[4例(4.1％)vs.31例(34.4％),x2=28.211,P=0.000],术后住院时间短[(5.0±1.3)d vs.(6.9±1.3)d,t=-10.106,P=0.000],但手术时间长[(120.2±39.3)min vs.(99.8±36.8)min,t=3.646,P=0.000]；住院费用高[(7216.0±850.9)元vs.(6531.6±875.6)元,t=5.419,P=0.000].2组术后病率和并发症发生率差异无显著性(P＞0.05).2组术后1个月肌瘤残留率、术后6个月后肌瘤复发率差异均无显著性(P＞0.05). 结论 腹腔镜子宫肌瘤剔除术是一种安全、可行的微创手术方式,但仍有一定的局限性,并不能完全代替开腹手术.
展开▼
