Five-Year Lapsed: Review of Laparoscopic Myomectomy versus Open Myomectomy in Putrajaya Hospital.
Five-Year Lapsed: Review of Laparoscopic Myomectomy versus Open Myomectomy in Putrajaya Hospital.
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DOI：
10.4103/gmit.gmit_38_18
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发表时间：
2018-10
期刊：
影响因子：
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通讯作者：
Ghazali WAHW
中科院分区：
文献类型：
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作者：
D'Silva EC;Muda AM;Safiee AI;Ghazali WAHW
本研究旨在研究腹腔镜子宫肌瘤切除术（LM）与开放式子宫肌瘤切除术（OM）的发病率，包括术中失血量、手术时间、住院时间和并发症，并评价适合LM病例的选择标准。这是一项回顾性研究。本研究在三级医院进行。对2010年1月至2014年11月期间接受LM的67名女性、接受OM的22名女性和接受腹腔镜手术的14名女性的记录进行了审查。10 cm以下的肌瘤通过LM切除，而10 cm以上的大多数肌瘤通过OM处理。子宫肌瘤的数量和重量与中转开腹率显著相关，中转开腹率为17%。LM组的平均失血量显著低于OM组和腹腔镜转换组。LM组的住院时间（2 ± 1天）也显著短于OM组和剖腹术组（3 ± 1天）。与OM（50%）和腹腔镜手术（57.1%）相比，大多数接受LM的女性（88%）没有术后并发症。在接受肌瘤切除术的妇女中，切除肌瘤的数量和手术时间与失血量呈正相关。LM是切除直径达10 cm且数量<5个肌瘤的理想手术方法，而OM适用于多发（5个或更多）、较大肌瘤（> 10 cm）和位置较深的肌瘤。术前评估肌瘤的大小和数量是必要的，以避免中转开腹，减少术中和术后并发症。
This study aimed to investigate the morbidity of laparoscopic myomectomy (LM) versus open myomectomy (OM), including intraoperative blood loss, duration of surgery, hospital stay, and complications and to evaluate the criteria for selection of cases suitable for LM. This was a retrospective study. This study was conducted at tertiary hospital. The records of 67 women who underwent LM, 22 women who underwent OM, and 14 women who had laparo-conversion from January 2010 to November 2014 were reviewed. Fibroids up to 10 cm were removed by LM, while most fibroids more than 10 cm were managed through OM. The number and weight of myomas are significantly associated with laparo-conversion, with a rate of 17%. Mean blood loss was significantly reduced in LM group than the OM and laparo-conversion groups. Duration of hospital stay was also significantly less in LM (2 ± 1 days) compared to both OM and laparo-conversion groups (3 ± 1 days). Most women underwent LM (88%) had no postoperative complications compared to OM (50%) and laparo-conversion (57.1%). The number of fibroids removed and duration of surgery was positively correlated with blood loss in the women who underwent myomectomy. LM is an ideal surgical approach for removal of fibroids which are up to 10 cm diameter and <5 in number, while OM is useful for cases with multiple (5 or more), larger fibroids (>10 cm), and deeply located fibroids. Preoperative evaluation of the size and number of myomas is necessary to avoid laparo-conversion and to reduce intraoperative and postoperative complications.