Clinical Comparative Research Of Laparoscopic Myomectomy Within And Without Uterine Artery

Objective:To analyze the clinical effectiveness between laparoscopic myomectomy after uterine artery occlusion and laparoscopic myomectomy without uterine artery occlusion and study clinical value of uterine artery occlusion beforehand in laparoscopic myomectomy.Methods:The clinical data of103patients with uterine fibroids from the second affiliated hospital of Suzhou University and Suzhou Traditional Chinese and western medicine Hospital were reviewed retrospectively. The cases were required to preserve the uterus and accepted laparoscopic myomectomy. The patients were randomly divided into2groups. There are63patients in observation group including34cases with multiple myomata and29cases with single myomata. Blocked uterine artery before laparoscopic myomectomy. Another40patients in control group, including21cases with multiple myomata and19cases with single myomata. Did the surgery of laparoscopic myomectomy directly and no deal with uterine artery. Dissected and separated the uterine artery under laparoscopic, and closed it with PK knife or Bipolar electric instrument. Cut the fibroids surface using monopole hook, stripping excluding the fibroids. Suture the incision surface of uterus. Compare the significance in operation time, blood loss, in patient days.Results:The blood loss of laparoscopic myomectomy after uterine artery occlusion was less than laparoscopic myomectomy without uterine artery occlusion, especially during an operation of multiple uterine fibroids. Among those patients with uterine fibroids more than7cm in diameter, their operation time was longer but less blood loosing in multiple uterine fibroids than single fibroid myomectomy. Also less blood loosing of single fibroid myomectomy in observation group but no significance in operation time. There was no significance in hospitalization days, postoperative fever and postoperative exhaust time.. Excessive menstrual symptoms was remitted and the currency rate of fibroids was lower after uterine artery occlusion.Conclusion:1、Laparoscopic myomectomy after uterine artery occlusion could reduce intra-operative bleeding, reserved uterus, and inhibit the recurrence of uterine fibroids.2、Broaden the indication of laparoscopic myomectomy, reducing the post operative complications and improve the quality of operation and postoperative symptoms.3、Though the higher operation technical requirement of surgeon but its worth to promoting.