The Clinical Comparative Study Between Abdo-Minal Myomectomy And Laparoscopic Myomectomy

ObjectiveCompare the advantages and disadvantages of laparoscopic and conventionallaparotomy myomectomy, to observe the clinical curative effect of both, to explore theclinical laparoscopic myomectomy indications, in order to evaluate the clinical value oflaparoscopic myomectomy.MethodA retrospective analysis of January2012to July2013in Affiliated Hospital ofTaishan Medical University Department of gynaecology and obstetrics myomectomy of atotal of105cases, including56cases underwent laparoscopic myomectomy, laparoscopic;underwent abdominal myomectomy in49cases, abdominal group. Compare the twogroups in operation time, bleeding, anal exhaust time,postoperative complications,postoperative analgesic use rate, postoperative hospital stay, tumor residual rate andrecurrent rate between this two groups.ResultTwo groups of patient’s age, weight, hemoglobin content, history of pelvic surgery,such as hypertension medical history and general,situation had no statisticalsignificance.(P>0.05).The two groups in the number of myoma, leiomyoma, positiondifference inmaximal diameter had no statistical significance (P>0.05);The averageoperation time of laparoscopic group (94.46±24.27) minutes,longer than the abdominalgroup (81.12±18.46) minutes, the difference was statistically significant (P<0.05);Thelaparoscopic group the mean intraoperative bleeding was (77.14±24.02)ml, less than theabdominal group (103.27±30.37) ml, the difference was statistically significant (P<0.05);The laparoscopic group postoperative anal exhaust time averaged (19.20±2.05)h, theaverage time of abdominal group (22.27±2.07) h, there was statistically significantdifference between them (P<0.05); Postoperative analgesic use rate of laparoscopic group 46.43%, the abdominal group61.22%, two groups had no significant difference (P>0.05);The average hospitalization time after the laparoscopic group (5.18±0.90) days,the averageis less than the abdominal group (6.51±1.26)days, the two groups had significant difference(P<0.05). The laparoscopic group the incidence of postoperative complications was1.79%less than the abdominal group, the incidence rate of6.12%, no significantdifferences between the two groups(P>0.05). Rate of5.36%residual myoma laparoscopicsurgery, laparotomy hysteromyomaresidual rate was4.08%, no significant differencesbetween the two groups (P>0.05);123.21%the laparoscopic group the recurrence rate, theopen group the recurrence rate was10.64%, no significant differences between the twogroups(P>0.05). Laparoscopic operation was successfully performed, no case wasconverted to laparotomy.ConclusionLaparoscopic myomectomy with less trauma, less bleeding, postoperativepain,recovery of gastrointestinal function has the advantages of fast, scar small, shorthospitalization time, and does not increase postoperative leiomyoma residual rate andrecurrence rate in recent years, medical institutions and patients to acceptmore. Inlaparoscopic operation indications strictly follow the premise of operation,appropriate torelax the laparoscopic myomectomy indication is feasible, and can make more patientsbenefit from it. But laparoscopic operation has its limitations, can not completely replaceabdominal operation.