[1]李海侠＊ 尤红霞.腹腔镜巨大子宫切除术200例体会[J].中国微创外科杂志,2014,14(11):1052-1054.
　Li Haixia,You Hongxia..Laparoscopic Hysterectomy for Large Uterus: Experience of 200 Cases[J].Chinese Journal of Minimally Invasive Surgery,2014,14(11):1052-1054.
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腹腔镜巨大子宫切除术200例体会()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
14
期数:
2014年11期
页码:
1052-1054
栏目:
经验交流
出版日期:
2014-11-20

文章信息/Info

Title:
Laparoscopic Hysterectomy for Large Uterus: Experience of 200 Cases
作者:
李海侠＊ 尤红霞
汉中市人民医院妇产科，汉中723000
Author(s):
Li Haixia;  You Hongxia.
Department of Obstetrics & Gynecology, Hanzhong City People’s Hospital，Hanzhong 723000, China
关键词:
腹腔镜; 大子宫切除术; 子宫血管
Keywords:
Laparoscope; Resection of large uterus; Uterine vessel
分类号:
R713.4+2
文献标志码:
B
摘要:
目的探讨腹腔镜巨大子宫切除的可行性、安全性。方法2010年1月~2013年12月对子宫超过孕3个月的巨大子宫行腹腔镜全子宫切除术，第一穿刺孔位于宫底上5 cm，手术关键步骤是恰当处理子宫血管，选择子宫动脉上行支进行电凝，分前、后、外侧切割子宫血管。结果200例均在腹腔镜下完成手术，无一例中转开腹。手术时间80~170 min，平均120 min；术中出血量20~250 ml，平均60 ml，无因术中出血致输血者。2例术后3 d发生下肢静脉血栓，抗凝治疗后痊愈。2例术后15 d阴道残端炎，阴道放置甲硝唑粉末后治愈。1例术后1个月发生阴道残端出血，缝合2针后治愈。余均无严重并发症发生。术后住院（5±2）d。144例随访6个月，阴道残端愈合良好，B超示双肾输尿管正常，盆腔未见异常。结论使用双极电凝行腹腔镜巨大子宫切除术、安全、可行。
Abstract:
ObjectiveTo explore the feasibility and safety of laparoscopic resection of large uterus. MethodsWe performed laparoscopic hysterectomy in patients who had more than 3 months pregnant huge uterus in our hospital from January 2010 to December 2013. The mirror trocar was introduced at 5 cm above fundus. Surgical key steps were appropriate management of uterine blood vessels, electrical coagulation of the ascending uterine artery, and dissection of uterine vessels from front, rear, and lateral sides. ResultsThe laparoscopic surgery was completed in all the 200 cases, without conversion to laparotomy.The operation time was 80-170 min,with a mean of 120 min;the blood loss was 20-250 ml,with a mean of 60 ml.No blood transfusion was required due to hemorrhage during operation. Two cases developed deep vein thrombosis at the third day after surgery，and were cured by anticoagulant therapy. Two patients with vaginal stump inflammation at 15 postoperative day were cured by applying the metronidazole powder at vaginal. One patient were sutured by 2 stitches for vaginal stump bleeding at the first month after the operation. The remaining patients had no serious complications. Postoperative hospital stay was (5±2) days. Followup reviews in 144 patients for 6 months found satisfactory heal of the vaginal stump, normal ultrasonographic results of bilateral ureters, and no abnormity in the pelvic cavity.ConclusionLaparoscopic hysterectomy of large uterus with bipolar coagulation is safe and feasible.

参考文献/References:

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2014-11-20