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Objective To examine the hemostatic effect of oxytocin in laparoscopic myomectomy,and to clarify the optimal dosage of oxytocin in laparoscopic myomectomy. Methods From January 2016 to July 2017, ninety patients with myoma of uterus who underwent laparoscopic myomectomy in Tangshan Union Medical College Hospital were divided into two groups: group A and group B,45 cases in each group. In group A,the patients were given 20U oxytocin and 5％ glucose injection 250 ml via intravenous drip, and in group B, the patients were injected with 20U oxytocin on the muscular wall of uterus myoma during operation. The preoperative, postoperative basic situation, intraoperative blood loss, operation time, intraoperative and postoperative adverse reactions and the time of hospitalization were compared between the two groups. Results The average amount of blood loss during operation in group B was (76. 5±15. 8) ml,significantly lower than that in group A((99. 8±20. 7) ml),and the operation time in group B was (71. 2±10. 7) min,shorter than that in group A ((90. 1±18. 4) min) The difference was statistically significant (t=1. 788、2. 878,P<0. 05). At 5 minutes,30 minutes and 180 minutes after medication, the systolic blood pressure of patients in group A was (132. 2±1. 4) mmHg,(120. 7±5. 3) mmHg,(110. 9±1. 8) mmHg and the diastolic blood pressure was (80. 9 ±12. 5) mmHg,(71. 4±12. 6)mmHg,(70. 1±2. 8) mmHg,while the systolic blood pressure in the group B was (140. 4±11. 1) mmHg,(131. 2±4. 5) mmHg,(121. 4±11. 2) mmHg and the diastolic blood pressure was (93. 4±8. 1) mmHg,(86. 4±7. 1) mmHg,(81. 1±1. 5) mmHg,the differences were statistically significant (systolic blood pressure:Ftime=68. 57,P<0. 001;FgrouP=16. 54,P<0. 001;Finteraction=4. 34,P=0. 011;diastolic blood pressure:Ftime=45. 16,P<0. 001;FgrouP=10. 79,P=0. 024;F interaction=4. 16,P=0. 037);at the same treatment time,the systolic blood pressure and diastolic blood pressure in group B were higher than those in group A,the differences were statistically significant (P<0.05).Conclusion Laparoscopic uterine myomectomy with oxytocin hemostasis, intrauterine myoma wall injection method can significantly reduce intraoperative blood loss and shorten the operation time,the effect is obviously better than intravenous drip,and it is conducive to the operation.
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Objective To observe the influence of laparoscopic hysteromyomectomy ( LSHM) and hysterectomy ( TH) on ovarian function in patients with uterine fibroids ( UF) .Methods 96 UF patients with accepted surgery in our hospital were selected .The patients were randomly divided into observation group and control group by random number table method ,48 cases in each group .LSHM was used for surgery in the observation group ,while the control group accepted TH surgery.E2,AMH,FSH and LH levels before and after surgery,the operation time,intraoperative blood loss,flatus time and average length of stay ,as well as proportion of perimenopausal symptoms in the two groups were recorded and compared .Results The operation time ,intraoperative blood loss ,flatus time and average length of stay in the observation group were (65.6 ±13.2)min,(82.4 ±6.2)mL,(20.4 ±4.6)h and (5.2 ±1.2)d,respec-tively,which in the control group were (76.5 ±15.6)min,(118.6 ±8.9)mL,(34.2 ±5.4)h and (8.3 ±1.2)d,the differences were statistically significant (t=3.695,P=0.00;t=23.120,P=0.00;t=13.482,P=0.00;t=12.650, P=0.00).The differences of E2,FSH,LH and AMH levels before surgery were not statistically significant (all P>0.05).After surgery,the E2 and AMH levels were significantly higher in the observation group (t=22.630,P=0.00;t=5.910,P=0.00),and FSH and LH levels were significantly lower in the observation group (t=6.853,P=0.00;t=7.024,P=0.00).The incidence rate of perimenopausal symptoms in observation group was 8.3％(4/48),which in the control group was 29.2％ (14/48),the difference was statistically significant (χ2 =6.838,P =0.00). Conclusion LSHM is helpful to protect UF patients'ovarian function ,with faster postoperative recovery ,and deserves further promotion in clinical practice .
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Objective To investigate the hemostatic effect of different administration Methods of hemabate in laparoscopic myomectomy, and to clarify the best mode of hemabate in laparoscopic myomectomy.Methods Ninety patients were randomly divided into two groups,group A and group B,45 patients in each group,group A was given intramuscular injection of hemabate 0.25 mg 30 minutes before operation,and in group B,the patients were injected with hemabate 0.25 mg at the muscular wall of uterine leiomyoma during operation.The preoperative,postoperative basic situation,intraoperative blood loss,operation time,intraoperative and postoperative adverse reactions and length of hospital stay were compared between the two groups.Results The average amount of blood loss during operation in the group B was(67.6±17.6)ml, significantly less than that in the group A((88.7±21.6)ml),the operation time in the group B was(68.1 ±18.1)min,shorter than that in the group A(83.1 ± 17.5)min(t=1.877,2.787,P<0.05).The systolic blood pressure of patients in the group A after 15,30,45 and 180 minutes of medication were(155.6±10.31) mmHg,(141.2±5.7)mmHg,(138.6±10.3)mmHg,(127.5±7.4)mmHg,respectively and the diastolic blood pressure were(90.5±8.8)mmHg,(85.5±8.0)mmHg,(80.6±6.3)mmHg,(72.2±7.1)mmHg,while the systolic blood pressure were(141.1±8.3)mmHg,(120.5±6.1)mmHg,(125.7±4.6)mmHg,(118.8±5.5) mmHg and diastolic blood pressure were(81.2 ± 11.4)mmHg,(70.4 ± 10.1)mmHg,(71.5 ± 5.8)mmHg, (66.5±1.2)mmHg in the group B,the differences were statistically significant(systolic blood pressure,Ftime=79.75,P<0.001;FgrouP=25.45,P<0.001; Finteraction=5.48,P=0.041; diastolic blood pressure,Ftime=46.61,P<0.001;FgrouP=11.97,P=0.021,Finteraction=4.05,P=0.034).Conclusion The application of hemabate for hemostasis in laparoscopic myomectomy surgery and uterine fibroids at the muscle wall injection medication can significantly reduce the amount of blood loss during operation,shorten the operation time,and at the same time,the effect on blood pressure was lower than that by preoperative hemabate,is beneficial to the development of operation,with obvious advantages.
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Objective To investigate the hemostatic effect of different administration Methods of hemabate in laparoscopic myomectomy, and to clarify the best mode of hemabate in laparoscopic myomectomy.Methods Ninety patients were randomly divided into two groups,group A and group B,45 patients in each group,group A was given intramuscular injection of hemabate 0.25 mg 30 minutes before operation,and in group B,the patients were injected with hemabate 0.25 mg at the muscular wall of uterine leiomyoma during operation.The preoperative,postoperative basic situation,intraoperative blood loss,operation time,intraoperative and postoperative adverse reactions and length of hospital stay were compared between the two groups.Results The average amount of blood loss during operation in the group B was(67.6±17.6)ml, significantly less than that in the group A((88.7±21.6)ml),the operation time in the group B was(68.1 ±18.1)min,shorter than that in the group A(83.1 ± 17.5)min(t=1.877,2.787,P<0.05).The systolic blood pressure of patients in the group A after 15,30,45 and 180 minutes of medication were(155.6±10.31) mmHg,(141.2±5.7)mmHg,(138.6±10.3)mmHg,(127.5±7.4)mmHg,respectively and the diastolic blood pressure were(90.5±8.8)mmHg,(85.5±8.0)mmHg,(80.6±6.3)mmHg,(72.2±7.1)mmHg,while the systolic blood pressure were(141.1±8.3)mmHg,(120.5±6.1)mmHg,(125.7±4.6)mmHg,(118.8±5.5) mmHg and diastolic blood pressure were(81.2 ± 11.4)mmHg,(70.4 ± 10.1)mmHg,(71.5 ± 5.8)mmHg, (66.5±1.2)mmHg in the group B,the differences were statistically significant(systolic blood pressure,Ftime=79.75,P<0.001;FgrouP=25.45,P<0.001; Finteraction=5.48,P=0.041; diastolic blood pressure,Ftime=46.61,P<0.001;FgrouP=11.97,P=0.021,Finteraction=4.05,P=0.034).Conclusion The application of hemabate for hemostasis in laparoscopic myomectomy surgery and uterine fibroids at the muscle wall injection medication can significantly reduce the amount of blood loss during operation,shorten the operation time,and at the same time,the effect on blood pressure was lower than that by preoperative hemabate,is beneficial to the development of operation,with obvious advantages.
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Objective To discuss the safety and advantages of prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus. Methods The clinical data of patients who were admitted into our hospital from March 2013 to Janaury 2015 and received transvaginal hysteromyomectomy were retrospectively analyzed. They were divided into group A ( prone-straddle position, 30 cases) and group B (traditional lithotomy position,24 cases). The exposure of operative field, convenience of operation, time of the placement, time of operation, patient satisfaction, as well as patients’ heart rate, blood pressure, and oxyhemoglobin saturation were observed and ana-lyzed. Results Compared with the lithotomy position, there were significant differences in the time of the placement and the time of opera-tion in the patients treated by prone-straddle position. The patients with prone-straddle position cooperated well, and there was no obvious discomfort. Their vital signs were stable during the operation. The operative field during prone-straddle position exposed better and it was more convenient which make the operation became easier for both the operators and nurses. Conclusion Prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus is safe and practicable, and it is valuable for clinical application.
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Objective To discuss the clinical advantage of laparoscopic uterine fibroids cystectomy.Methods Retrospectively analyzed fifty cases underwent laparoscopic uterine fibroids divest resection(A group),between forty cases sigmoidectomy uterine fibroids divest resection and forty cases transvaginal uterine fibroids divest resection(B group),preoperative and postoperative patients.Results Observations in fifty cases,all successfully carried laparoscopic surgery,peri-operative bleeding and postoperative recovery time in hospital days were than less the control group,did not happen any complications.Conclusion The laparoscopic hysteromyomectomy was the ideal procedure for retaininy organs,with the advantage of minimal invision,less operative blood loss,and it had quick recovery and short hospitalization.
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Objective To investigate the clinical value of laparoscopic hysteromyomectomy.Methods The clinical data of 98 cases of laparoscopic hysteromyomectomy(LM)and 76 cases of transabdominal Myomectomy(TAM)were retrospectively analyzed and comparison was made on the operative time,operative blood loss,postoperative blind enema time,body temperature recovery time,the rate of postoperative complicating disease and hospitalization after operation.Result Though the mean opertative time is the same,the mean operative blood loss,the mean body temperature recovery time,postoperative blind enema time,and the mean hospitalization was smaller in LM group than in TAM group(P＜0.05).Conclusion Laparoscopic hysteromyomectomy has the advantage of minimal invasion,short in-hospital days,fast recovery and low complication rate,which is an ideal treatment of hysteromyoma.
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Objective To evaluate the effects of different laparoscopic approaches for hysteromyomectomy. Methods Hysteromyomectomy was performed on 126 patients who required surgical treatment and preservation of the uterus from August 2000 to December 2002 with different laparoscopic approaches. A follow-up for 2-28 months was conducted in all patients. Results There were 70 cases of subserous fibroids, 53 cases intramural fibroids, and 3 broad ligament fibroids in those 126 patients. The average diameter of the fibroids was 6.1 cm (3-12 cm). The diameter of the fibroids less than 5 cm was found in 33 patients (26.2%), but equal to or larger than 5 cm in 93 patients (73.8%). A single myoma was found in 57 patients (45.2%), but numerous myomas in 69 patients (54.8%). Hysteromyomectomy, hysteromyomectomy and uterine artery blockage, and hysteromyomectomy and temporary uterine artery blockage were performed on 26, 70, and 30 patients, respectively. Operations were successful in all patients. There were no intra- and post-operative complications. Conclusion Different laparoscopic approaches for hysteromyomectomy can result in satisfactory clinical outcomes when different case properties and different requirements of patients are taken into consideration.
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0 05). The blood loss in group I (160?40ml)was significantly less than that in group II(190?60ml)(P
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Objective To evaluate the clinical significance of laparoscopic resection for large intramural hysteromyoma. Methods A retrospective analysis was made concerning 42 cases of single intramural hysteromyoma as large as 6～10 cm in diameter: 24 cases underwent laparoscopic hysteromyomectomy and 18 cases received open resection. Intra- and post-operative parameters between the two groups were compared. Results All operations in the two groups were successfully completed without complications. The operative time was significantly longer in the laparoscopic group (89.0?26.9 min) than that in the open group (63.3?20.1 min) ( t=3.400,P =0.002). No statistical difference was observed in the intraoperative blood loss between the laparoscopic group (93.6?65.9 ml) and the open group (100.0?48.7 ml) ( t=-0.347, P=0.731) . The analgesic requirement was less in the laparoscopic group (2 out of 24 cases ) than that in the open group (9 out of 18 cases) ( ? 2 =7.208, P =0.007). The time to first flatus was shorter in the laparoscopic group (23.5?11.3 h) than that in the open group (32.0?13.6 h) ( t=-2.211, P =0.033). The postoperative pyrexia rate was significantly lower in the laparoscopic group (2/24) than that in the open group (7/18) ( ? 2=4.033, P =0.045). Conclusions Laparoscopic resection for larger intramural hysteromyoma is safe and reliable. As compared with open hysteromyomectomy, it offers more rapid recovery and lower postoperative pyrexia rate, as well as the same amount of blood loss. Its prolonged operative time may be associated with the relatively large size of the hysteromyoma.