目的研究阴式子宫肌瘤剔除术的可行性和安全性。方法回顾性分析从2008年3月至2013年3月问,于中国医科大学附属盛京医院住院接受阴式子宫肌瘤剔除术共138例患者的临床资料。记录并分析患者的子宫肌瘤数目及部位,手术时间,术中失血量、术后并发症、术后肠道功能恢复时间以及术后住院天数等相关参数。结果135例患者成功施行阴式子宫肌瘤剔除术,手术成功率97.8%。平均手术时间为(42.4±19.6)min,平均术中失血量为(86.7±54.8)mL,平均术后肠道功能恢复时间(1.2±0.7)d,平均术后住院天数(4.5±2.8)d。共有14例出现术后高热,术后病率为10.4%。在随访期间仅有4例病例出现肿瘤复发,复发率3.2%。结论严格掌握手术适应证及熟练运用阴式手术技巧,阴式子宫肌瘤剔除术是安全可行的。
Objective To explore the feasibihty and safety of vaginal myomectomy. Methods From March 2008 to March 2013,138 patients with symptomatic myomas were admired in Shengjing Hospital of China Medical University for vaginal myomeetomy. Operative time, blood loss amount, the number and position of uterine fibroids, postoperative complications, postoperative recovery time of gastrointestinal function, and hospitalization time of these patients were retrospectively analyzed. Results Myomectomy was performed vaginally in 135 (97.8%) patients. The average size of uterus was (8.8±4.1) gestational age. The mean operating time and the mean operative blood loss were (42.4±19.6) minutes and (86.7±54.8) mL, respectively. Intestitinal function average recovery time and hospital stay after operation were ( 1.2± 0.7 ) and (4.5 ± 2.8) days, respectively. 14 ( 10.4% ) patients developed febrile morbidity and experienced a high postoperative temperature. Only four (3.2%) patients had a tumor recurrence during the following-up period. Conclusion Vaginal myomectomy is a safe, feasible and minimally invasive procedure with strict control of surgical indication and skilled vaginal surgical techniques, but it is not a complete alternative of open and laparoscopie surgery.