CAJ | 학술논문

目的：探讨腹腔镜切除大子宫的可行性。方法对2010年1月至2012年12月本院和东莞东华医院收治的38例大子宫（体积如孕12～20周大小）在腹腔镜下行子宫全切除。术中通过上移进腹穿刺点、套扎后旋切瘤体、缩小子宫体等方法完成子宫全切术。结果38例患者术中根据子宫大小酌情将置镜孔及操作孔相应上移，以扩大镜下视野及操作空间，并采用逐步套扎的方法，逐步旋切缩小宫体，释放出被宫体占据的手术空间，克服了手术空间狭窄，使本组大子宫全切手术顺利完成，无一例中转开腹。结论腹腔镜大子宫切除，术中采用上移穿刺点、套扎后旋切缩小子宫体等方法能有效地为手术创造操作空间，有助于提高腹腔镜切除大子宫的安全性和可行性。
목적：탐토복강경절제대자궁적가행성。방법대2010년1월지2012년12월본원화동완동화의원수치적38례대자궁（체적여잉12～20주대소）재복강경하행자궁전절제。술중통과상이진복천자점、투찰후선절류체、축소자궁체등방법완성자궁전절술。결과38례환자술중근거자궁대소작정장치경공급조작공상응상이，이확대경하시야급조작공간，병채용축보투찰적방법，축보선절축소궁체，석방출피궁체점거적수술공간，극복료수술공간협착，사본조대자궁전절수술순리완성，무일례중전개복。결론복강경대자궁절제，술중채용상이천자점、투찰후선절축소자궁체등방법능유효지위수술창조조작공간，유조우제고복강경절제대자궁적안전성화가행성。
Objective To explore the feasibility of laparoscopic resection of large uterus .Methods Patients with large uterus ( volume such as 12~20 weeks pregnant size ) by the implementation of laparoscopic hysterectomy were collected in our hospital and Dongguan Tung Wah Hospital from January 2010 to December 2012 .The uterus was carried out a complete hysterectomy through intra-operation by upward into the abdominal puncture point , ligation cutting tumor , and reduction of the uterine body method .Results A total of 38 patients was carried out hysterectomy operation .According to the size of uterus , the lens opening and operating hole was cor-responding upward to expand the horizons and operating space under microscope , and the use of stepwise ligation method to gradually cut reduced uterine body and release the operation space for overcoming the narrow operation space .Each hysterectomy operation was smoothly completed , and no case was converted to laparotomy .Conclusions Laparoscopic hysterectomy with the puncture point , and moving after ligation cutting shrink small palace body method can effectively create space for operation , and safety and feasibility of lap-aroscopic resection is helpful to improve the large uterus .