Clinical application value of transvaginal extraperitoneal hysteromyomectomy
Objective To explore the clinical application value of transvaginal extraperitoneal myomectomy.Methods A retrospective study was conducted on 380 patients who underwent transvaginal myomectomy for lower uterine seg-ment or cervical myoma in the 908th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Ar-my,Jiangxi Maternal and Child Health Hospital,Jiangxi Provincial People's Hospital and the Second People's Hospital of Pingxiang,Jiangxi Province from July 2015 to July 2023.They were divided into the study group(transvaginal extra-peritoneal myomectomy)with 180 cases and the control group(transvaginal intraperitoneal myomectomy)with 200 cas-es.According to the patients'history of lower uterine segment surgery,the operation time,intraoperative blood loss,in-traoperative injury rate,postoperative pain score,anal exhaust time,and postoperative morbidity of the two sur-gical methods were compared.Results Whether with or without lower uterine segment surgery history,the anal exhaust time(days)of the study group(1.1±0.7)was shorter than that of the control group(2.0±0.8)(P=0.03),the postoperative pain score(2.9±0.6)was lower than that of the control group(4.9±1.2)(P=0.02),and the postoperative morbidity(8.2％)was lower than that of the control group(21.7％)(P=0.01).In patients with history of uterine operation,the operation time(min)(73.7±15.1)in the study group was shorter than that in the control group(98.3±16.1)(P=0.03),the intraoperative blood loss(mL)(92.3±6.3)was less than that in the control group(159.7±15.2)(P=0.01),the incidence of intraoperative injury(0.0％)was lower than that in the control group(9.7％)(P=0.04),the postoperative pain score(3.2±0.8)was lower than that in the control group(5.3±1.4)(P=0.04),the anal exhaust time(days)(1.3±0.6)was shorter than that in the control group(2.7±0.7)(P=0.02),and the postoperative morbidity(8.6％)was lower than that in the control group(24.2％)(P=0.02).Conclusion Transvaginal extraperitone-al subsegmentectomy and cervical myomectomy is superior to intraperitoneal excision in early exhaust,reducing postop-erative infection and pain,especially for patients with history of uterine operation;extraperitoneal excision also has obvi-ous advantages in reducing operation time and blood loss and improving safety,which is worthy of clinical promotion.
万方数据
维普
