Therapeutic Effects of Transvaginal Cervical Myomectomy and Laparoscopic Cervical Myomectomy

doi:10.3877/cma.j.issn.1673-5250.2014.06.018

Objective

To explore the therapeutic effects of transvaginal cervical myomectomy and laparoscopic cervical myomectomy on patients who required to retain uterus.

Methods

A total of 72 inpatients in Center of Minimally Invasive Gynecology, Beijing Obstetrics and Gynecology Hospital from January 2012 to January 2014 with single cervical myoma were enrolled in this study. Their average age was (35.1 ±4.6) years old. The participants were randomly divided into two groups by digital table method, transvaginal cervical myomectomy group (n = 36) whose average age were (35.6 ±4.5) years old,and laparoscopic cervical myomectomy group (n = 36) whose average age were (34.2 ± 4.8) years old. The maximum diameters of cervical myoma in transvaginal cervical myomectomy group and laparoscopic cervical myomectomy group were (5.2 ±2.4) cm and (4.9 ± 2.6) cm, respectively. The indices of observation, such as duration of operation, blood loss volume, maximum body temperature after operation, time of anal exhaust after operation, time of antibiotics use and hospitalization time were analyzed by statisticsal method. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Beijing Obstetrics and Gynecology Hospital. Informed consent was obtained from all participants. There were no significance differences between two groups on average age and maximum diameter of cervical myoma (t= 1.552 9, 0.508 7 ; P>0.05).

Results

The operations were completed successfully in both two groups, without conversion to laparotomy, injury of adjacent organs or postoperative complications. The durations of operation in laparoscopic cervical myomectomy group and transvaginal cervical myomectomy group were (99.5 ± 45.5) min and (78.4 ± 25.3) min, respectively, blood loss volumes were (150.1 ± 88.5) mL and (116.4 ± 40.5) mL, respectively, and both showed significant difference (t = 2.431 8, 2.077 5; P<0.05). The maximum body temperatures after operation in laparoscopic cervical myomectomy group and transvaginal cervical myomectomy group showed no significant difference (t = 0.768 2, P>0.05) . The time of anal exhaust after operation in laparoscopic cervical myomectomy group and transvaginal cervical myomectomy group were (15.3 ± 5.3 ) h and (12.9 ± 4.2) h, respectively, durations of antibiotics treatment were (3.4 ± 2.5) d and (2.2 ± 1.2) d, respectively, hospitalization time were (5.2 ± 1.8) d and (4.4 ± 1.2) d, respectively, and all showed significant differences (t= 2.129 4, 2.596 4, 2.218 8 ; P< 0.05).

Conclusions

Transvaginal cervical myomectomy and laparoscopic cervical myomectomy are both safe and practicable. Patients after operation above have minor wound and rapid recovery from operation. Compared with laparoscopic cervical myomectomy, transvaginal cervical myomectomy have shorter operation time, 1ess blood loss volumes, shorter time of anal exhaust after operation, shorter time of antibiotics treatment and less days of hospitalization, and thus more minimally invasive and worthy of promotion.

Key words: Cervical myoma, Cervical myomectomy, veginal, Cervical myomectomy, laparoscopic operation, Surgical procedures,minimally invasive

表1 宫颈肌瘤经腹腔镜组与经阴道组患者年龄、手术时间、术中出血量及肌瘤最大直径比较(±s)

Table 1 Comparison of the age, duration of operation, blood loss volume and maximum diameter of cervical myoma between transvaginal cervical myomectomy group and laparoscopic cervical myomectomy group (±s)

组别	例数	平均年龄（岁）	手术时间(min)	术中出血量(mL)	肌瘤最大直径(cm)
经腹腔镜组	36	35.1±4.6	99.5±45.5	150.1±88.5	5.2±2.4
经阴道组	36	34.2±4.8	78.4±25.3	116.4±40.5	4.9±2.6
t值		1.552 9	2.431 8	2.077 5	0.508 7
P值		>0.05	<0.05	<0.05	>0.05

表1 宫颈肌瘤经腹腔镜组与经阴道组患者年龄、手术时间、术中出血量及肌瘤最大直径比较(±s)

组别	例数	平均年龄（岁）	手术时间(min)	术中出血量(mL)	肌瘤最大直径(cm)
经腹腔镜组	36	35.1±4.6	99.5±45.5	150.1±88.5	5.2±2.4
经阴道组	36	34.2±4.8	78.4±25.3	116.4±40.5	4.9±2.6
t值		1.552 9	2.431 8	2.077 5	0.508 7
P值		>0.05	<0.05	<0.05	>0.05

表2 宫颈肌瘤经腹腔镜手术组与经阴道手术组患者术后恢复、治疗及住院情况比较(±s)

Table 2 Comparison of postoperative recovery,therapy and hospitalization time between transvaginal cervical myomectomy group and laparoscopic cervical myomectomy group (±s)

组别	例数	术后最高体温（℃）	肛门排气时间(h)	抗菌药物使用时间(d)	住院时间(d)
经腹腔镜组	36	37.7±1.2	15.3±5.3	3.4±2.5	5.2±1.8
经阴道组	36	37.5±1.0	12.9±4.2	2.2±1.2	4.4±1.2	0.768 2
t值		2.129 4	2.596 4	2.218 8
P值		>0.05	<0.05	<0.05	<0.05

表2 宫颈肌瘤经腹腔镜手术组与经阴道手术组患者术后恢复、治疗及住院情况比较(±s)

Table 2 Comparison of postoperative recovery,therapy and hospitalization time between transvaginal cervical myomectomy group and laparoscopic cervical myomectomy group (±s)

组别	例数	术后最高体温（℃）	肛门排气时间(h)	抗菌药物使用时间(d)	住院时间(d)
经腹腔镜组	36	37.7±1.2	15.3±5.3	3.4±2.5	5.2±1.8
经阴道组	36	37.5±1.0	12.9±4.2	2.2±1.2	4.4±1.2	0.768 2
t值		2.129 4	2.596 4	2.218 8
P值		>0.05	<0.05	<0.05	<0.05

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