关键词: 腹腔镜, 外科手术, 计算机辅助, 子宫切除术, 并发症, 肌瘤切除术

Abstract:

Abstract: Objective To study the influence factors and prevention measures of complication of laparoscopic uter⁃
ine surgery. Methods Patient who underwent laparoscopic uterine surgery were collected (n=415) and divided into hyster⁃
ectomy group (n=310) and myomectomy group (n=105). Intraoperative and postoperative complications such as gastrointesti⁃
nal injury, urinary injury and bleeding were recorded and compared between these two groups. Base on their uterine size, pa⁃
tients were divided into Group A (uterine volume ≤300 cm3), Group B (300 cm3 <uterine volume <600 cm3) and Group C
(uterine volume ≥ 600 cm3). Correlation between uterine size or pelvic adhesions with complications are investigated. Re⁃
sults A total of 23 patients (5.54%) were with complications. Complication occurrence in hysterectomy group was 4.51%
(14/310) and in myomectomy group was 8.57% (9/105) . The difference was not statistically significant (P > 0.05). The inci⁃
dence of intraoperative or postoperative bleeding was 1.93% (8/415) and incidence of gastrointestinal damage or urinary inju⁃
ry rate was 0.96% (8/415). The incidence of complications in group C was 20.0% (8/40) which is higher than that in group A
(2.8%; 5/179) and group B (5.1% ; 10/196). P < 0.01 in all cases. The difference between group A and group B was not signif⁃
icant (P > 0.05). The incidence in pelvic adhesions group is higher than that in the group without pelvic adhesions [8.3% (15/
180) vs 3.4% (8/235), P < 0.05]. Conclusion The incidence of complications in laparoscopic myomectomy was higher than
that in laparoscopic hysterectomy. When patients were without pelvic adhesions or with uterine volume < 600 cm3, laparo⁃
scopic surgery present least complication.

Key words: laparoscopy, surgery, computer-assisted , hysterectomy, concurrent disease, muscular tumor excision