CAJ | 학술논문

目的：回顾性分析因子宫肌瘤行腹腔镜手术的病例，探讨分碎器误用于子宫肉瘤的比率以及对其预后的影响。方法：选取2004年11月至2014年11月以诊断为子宫肌瘤入院并行腹腔镜下子宫切除术或子宫肌瘤切除术的患者，统计术后病理确诊或高度怀疑为子宫肉瘤的患者，分析其临床资料并随访其预后。结果：以诊断为子宫肌瘤入院并行腹腔镜子宫切除术或子宫肌瘤切除术的患者，共计2278例，经术后病理确诊或高度怀疑为子宫肉瘤患者共8例，约占0.35％（8/2278）；术后2例病理经上级医院再次复核后考虑为良性，另有一例术后8个月复发行二次手术治疗，术中发现大网膜、肠系膜、腹膜已有多发转移病灶。其余无复发或死亡病例。结论：腹腔镜下分碎器误用于子宫肉瘤的机会非常小，其在腹腔镜子宫肌瘤手术中的应用仍是可行的，但同时应重视分碎器所带来的不良后果并采取措施规避之。
목적：회고성분석인자궁기류행복강경수술적병례，탐토분쇄기오용우자궁육류적비솔이급대기예후적영향。방법：선취2004년11월지2014년11월이진단위자궁기류입원병행복강경하자궁절제술혹자궁기류절제술적환자，통계술후병리학진혹고도부의위자궁육류적환자，분석기림상자료병수방기예후。결과：이진단위자궁기류입원병행복강경자궁절제술혹자궁기류절제술적환자，공계2278례，경술후병리학진혹고도부의위자궁육류환자공8례，약점0.35％（8/2278）；술후2례병리경상급의원재차복핵후고필위량성，령유일례술후8개월복발행이차수술치료，술중발현대망막、장계막、복막이유다발전이병조。기여무복발혹사망병례。결론：복강경하분쇄기오용우자궁육류적궤회비상소，기재복강경자궁기류수술중적응용잉시가행적，단동시응중시분쇄기소대래적불량후과병채취조시규피지。
Objective:Through the retrospective analysis of the cases of laparoscopic surgery for uterine fibroids,a study was done to investigate the ratio of laparoscopic morcellator mistakenly applied to uterine sarcoma and its influ-ence on prognosis. Methods:From November 2004 to November 2014,those patients,who were admitted to hospital for uterine fibroids and choosed laparoscopic hysterectomy or myomectomy for the first operation,were selected. Among them,the patients diagnosed or suspected with uterine sarcoma by postoperative pathology were selected. Results:The total number of the patients with laparoscopy hysterectomy or myomectomy for uterine fibroids was 2278. Amond them, the number of the patients diagnosed or highly suspected with uterine sarcoma by postoperative pathology was 8,ac-counts for about 0. 35%(8 / 2278). 2 cases were considered as benign by the superior hospital pathology review. An-other case accepted the second operation for recurrence after 8 month,and the greater omentum,peritoneum,and mes-entery had have multiple lesions. The rest of the cases were without recurrence or death. Conclusion:The opportunity of laparoscopic morcellator mistakenly for uterine sarcoma is very rare. Its application in the laparoscopic surgery can be still feasible,but at the same time we should pay more attention to the adverse consequences brought by the laparo-scopic morcellator and take steps to avoid them.