国际妇产科学杂志 ›› 2012, Vol. 39 ›› Issue (5): 416-420.

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腹腔镜手术治疗子宫肌瘤的临床应用决策

李 斌 , 邱君君, 华克勤   

  1. 200011 上海,复旦大学附属妇产科医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-10-15 发布日期:2012-10-15

The Clinical Decision Making of Laparoscopy for Uterine Leiomyoma

LI Bin,QIU Jun-jun,HUA Ke-qin   

  1. Department of Obstetrics and Gynecology,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China
  • Received:1900-01-01 Revised:1900-01-01 Published:2012-10-15 Online:2012-10-15

摘要: 子宫肌瘤是女性生殖器官最常见的良性肿瘤,多采用手术治疗。目前常采用的手术方案有经腹子宫肌瘤切除术、腹腔镜子宫肌瘤切除术、宫腔镜下子宫肌瘤切除术、射频消融术、聚焦超声术、子宫动脉栓塞术以及经腹、经腹腔镜或经阴道全子宫切除术等。近年来,随着腹腔镜器械的发展和手术技巧的成熟,腹腔镜手术治疗子宫肌瘤的临床应用日趋广泛。虽然腹腔镜手术具有创伤小、患者痛苦少、恢复快、住院时间短等很多临床优势,但目前就其手术指征、手术方式以及术中术后并发症等问题尚存争议,值得进一步研究和关注。重点阐述腹腔镜下子宫肌瘤切除术的适应证、禁忌证、手术方式和并发症以及腹腔镜下子宫切除术的手术指征和术式评价,以期探讨腹腔镜手术治疗子宫肌瘤的临床应用决策。

关键词: 腹腔镜, 肌瘤, 外科手术, 微创性, 妇科外科手术

Abstract: Uterine leiomyomata are the commonest neoplasms of the female reproductive system in the procreative age. In these cases operation is still a treatment of choice. Hysteroscopic,abdominal and laparoscopic myomectomy,abdominal,vaginal,and laparoscopic hysterectomy,radio frequency ablation,uterine artery embolization and focused ultrasound are now available. To date,with the advancement of surgical skills and laparoscopic instruments,clinical application of laparoscopy for uterine leiomyoma is increasingly widespread. Despite the fact that laparoscopy has proven its advantages of less trauma and ache as well as shorter hospital stay and recovery period,etc.,this technique remains controversial concerning the operative indication and procedures as well as intraoperative and postoperative complications,etc. Therefore,extensive investigation on laparoscopy for uterine leiomyoma is paramountly required. This study addresses the important aspects of the indications,contraindications,surgical procedures and complications for laparoscopic myomectomy and the operative indication and procedures for total laparoscopic hysterectomy in order to assess the clinical decision making of laparoscopy for uterine leiomyoma.

Key words: Laparoscopes, Myoma, Surgical procedures, minimally invasive, Gynecologic surgical procedures