임상연구 : 자궁근종 적출술에 있어서 미세절개개복술 ( Minilaparotomy ) 과 골반경수술과의 비교 고찰

Objective: This study investigates the safety and effectiveness of laparoscopic myomectomy by comparing with minilaparotomic myomectomy in terms of the operation time, hemorrhage, pain, complications and pregnancy rates after opration. Method: Total 56 patients who underwent myomectomy in Chonnam National University Hospital from January 1996 to December 2000 were included.26 subjects underwent minilaparotomy and 30 subjects laparoscopic myomectomy respectively. The number, size and place of uterine myoma, the operation time required, hemoglobin reduction, and operation indication were compared. The frequency of analgesics application, the period without analgesics injection, complications, and pregnancy rates after operation were investigated. Results: 1.The amount of hemorrhage and hemoglobin markedly decreased in laparoscopic myomectomy in comparison with minilaparotomy (P＜0.01). 2.Analgesics were much less frequently used in laparoscopic myomectomy than minilaparotomy (P<0.01). Also Analgesics were injected for a significantly shorter period after laparoscopic myomectomy (P<0.01). 3.There was no significant difference in operation time, hospital period and complications rates between two groups. 4.Total 24 patients conceived after myomectomy.12 of them belonged to minilaparotomy patients group and 13 patients to laparoscopic myomectomy group.10 patients of the former and 11 of the latter were delivered of a baby through elective cesarean section and there was no significant difference. One to each group tried vaginal delivery, and there was no complication such as uterine rupture. Conclusion: Laparoscopic myomectomy is a safe and effective to treat uterine myoma and better than minilaparotomy in terms of post operative pain and hemoglobin.