Analysis of effect of the three types of endometrioma excision technique

Objective:To investigate the safety and feasibility of the excision of uterine adenomyoma through laparoscopic assisted operation with small abdominal incision.Methods:The clinical data of 58 cases of uterine adenomyoma with reserved uterus in 2006 and 2007 were reviewed retrospectively.Among those cases,18 patients underwent laparoscopic assisted excavations with small abdominal incisions(Group Ⅰ),23 patients were treated with standard laparoscopic excavations(Group Ⅱ),and the remained 17 patients had adenomyoma excision through laparotomy(Group Ⅲ).All 58 patients were routinely administered with GnRH-a for 3 months after their operations.The operation time,blood loss during operation,the postoperative recovery,complications,recurrence rate of adenomyoma,and relief from menstrual cramps were then evaluated and compared.Results:The average duration of surgery in group Ⅰ and Ⅲ was significantly shorter compared to Group Ⅱ(P0.05);blood loss during operation,postoperative flatus time and hospital stay in Group Ⅰ and Ⅱ were significantly shorter compared to Group Ⅲ(P 0.05);No postoperative hemorrhage,dehiscence of uterus,or infection was observed in Group Ⅰ,1 patient had postoperative hemorrhage and dehiscence of uterus in Group Ⅱ,1 patient occurred steatosis and delayed union in Group Ⅲ.There were no significant differences among 3 groups on recurrence rate of adenomyoma and the relief of menstrual cramps after operations.Conclusions:Laparoscopic assisted uterine adenomyoma excavation with small abdominal incision,not only attains the effectiveness of abdominal surgery and all advantages of laparoscopic surgery,but avoids the difficulties in suturing,reduces blood loss,and lowers the risk of postoperative hemorrhage and uterine dehiscence in standard laparoscopic surgery,thus,is worthy of clinical application and popularization.