妇科腹腔镜手术中转开腹45例临床分析

目的探讨妇科腹腔镜手术中转开腹的原因。方法对我院2002年1月～2007年12月2630例腹腔镜手术中45例中转开腹的临床资料进行回顾性分析。结果中转开腹原因：特殊部位的子宫肌瘤25例（55.6%）,严重盆腹腔粘连10例（22.2%）,宫角妊娠3例（6.7%）,卵巢肿瘤3例（6.7%）,手术损伤3例（6.7%）,子宫腺肌瘤要求保留子宫1例（2.2%）。结论特殊部位的子宫肌瘤手术、盆腹腔粘连是妇科腹腔镜手术中转开腹的常见原因。术前加强评估可以减少手术中转开腹率,及时中转开腹可以减少并发症的发生。

Causes of Conversions to Open Surgery in Patients Receiving Gynecological Laparoscopic Operations: Report of 45 Cases

Objective To study the causes of conversion to open surgery in patients receiving gynecological laparoscopic operations. Methods From January 2002 to December 2007, totally 2630 patients received gynecological laparoseopy in our hospital; 45 of them were converted to open surgery. The data of the 45 cases were analyzed. Results The causes of conversion to open surgery included uterus myoma located at specific locations （25 cases, 55.6% ） , severe pelvic-abdominal adhesion （10 cases, 22.2%）, uterine horn pregnancy （3 cases, 6.7%）, ovarian tumors （3 cases, 6.7%）, surgical injury （3 cases, 6.7%） , and adenomyoma with requirement for uterus conservation （ 1 case, 2.2% ）. Conclusions Peculiar locations of uterine myoma and severe pelvic-abdominal adhesion are the main causes of conversion to open surgery during gynecological laparoseopy. Detailed preoperative evaluation can decrease the rate of the conversion rate. Right timing of the conversion may reduce complication rate.