(1)子宮筋腫・子宮腺筋症に対する腹腔鏡下腟式子宮全摘出術の安全な術式・適応の確立に関する研究(講演要旨,<特集>第58回学術講演会シンポジウム-4「安全性の向上をめざした婦人科良性腫瘍に対する内視鏡手術」)

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Vaginal hysterectomy(VH) is the method to remove the uterus surgically through the vagina by performing the whole procedure vaginally and provides lower surgical invasion than that of total abdominal hysterectomy(TAH). However, its indications have been restricted due to the extension of the vagina, the size of tumor, or the history of surgical approach. Therefore, surgical removal of the uterine myoma and adenomyosis has been predominantly performed through abdominal approach. In contrast, laparoscopically assisted vaginal hysterectomy(LAVH) has been recognized to provide a little invasion to the patients because of its smaller surgical wound in the abdomen. We performed LAVH in the cases that otherwise would have traditionally undergone TAH, and here is the results obtained from LAVH. 459 cases that underwent LAVH due to uterine myoma and adenomyosis between January, 1995 and December, 2005 were enrolled in this study. All cases were undergone using pneumoperitoneum under general anesthesia. We established the technique and indications with safety of LAVH for uterine myoma and adenomyosis, and TAH rate was reduced from 71.3% in 1995 to 32.0% in last four years. Secondary, we examined whether patients became candidates for LAVH when leuprorelin acetate was preoperatively administered to patients with large uterine myomas that seemed to require TAH(preoperative LP group), and to compare the results with those in patients who underwent LAVH alone during the same period(LAVH group). Although the preoperative LP group had significantly larger myomas than the LAVH group prior to treatment, a marked reduction in size was achieved through administration of leuprorelin, and the volume of the myoma after administration was not significantly different from the volume in the LAVH group. Thus, all patients in the preoperative LP group became suitable for LAVH or vaginal hysterectomy, suggesting the usefulness of preoperative administration of leuprorelin acetate.
社団法人日本産科婦人科学会の論文
2006-12-01

(1)子宮筋腫・子宮腺筋症に対する腹腔鏡下腟式子宮全摘出術の安全な術式・適応の確立に関する研究(講演要旨,<特集>第58回学術講演会シンポジウム-4「安全性の向上をめざした婦人科良性腫瘍に対する内視鏡手術」)

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