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世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 32-33页

作者： Marchionni M. Fambrini M. Zambelli V t.susini 朱晓明 Department of Gyne cology Perinatology and Human Reproduction University of Florence Florence I taly Dr.

Objective to evaluate the results of abdominal myomectomy for intramu ral and s ubserosal fibroids and to identify factors that influence the reproductive outco me after surgery. Design Retrospective analysis of a case series. Setting An aca demic department specializing in gynecologic surgery. Patient(s) A total of 72 w omen with intramural and subserosal fibroids submitted to abdominal myomectomy w ho wished to conceive after surgery. Intervention(s) Data were collected on clin ical characteristics, surgical features, and obstetric history before and after surgery. Main outcome measure(s) Conception rate, pregnancy loss, and live birth rate before and aft er surgery, as well as postoperative probability of conception according to sele cted clinical and fibroid characteristics. Result(s) Conception rate was 28%bef ore myomectomy and 70%after surgery. the corresponding figures were 69%and 25 %for pregnancy loss and 30%and 75%for live birth rate, respectively. Age the only significant and independent predictors of obstetric outcome by multivariate analysis. Conclusion(s) Our resu lts suggest that abdominal myomectomy might improve reproductive outcome in pati ents with intramural and subserosal fibroids. the reproductive performance was p articularly good when the patientswere younger than 30 years and had a single my oma to remove.

关键词：子宫肌瘤切除术活产率手术指征孕产史受孕率专业科室预测术多元回归分析

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维普期刊数据库

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经阴道和经腹子宫切除术治疗老年子宫内膜癌效果的比较

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世界核心医学期刊文摘（妇产科学分册） 2005年第6期1卷 45-46页

作者： susini t. Massi G. Amunni G. 张家墅程金湘 Department of Gynecology Perinatology and Human Reproduction University of Florence Florence Italy

the purpose of this study was to analyze the outcome of vaginal and abdominal hysterectomy for treatment of endometrial cancer in elderly patients. In a retrospective series of 171 patients with age ≥ 70 years and at stages I- III, we evaluated operative and hospitalization data, as well as morbidity, mortality, and long- term survival associated with vaginal and abdominal hysterectomy. A total of 128 patients were operated on with vaginal hysterectomy and 43 cases underwent abdominal hysterectomy. Medically compromised patients were significantly more frequent in the vaginal surgery group (P = 0.01). Overall, the 10- year disease- specific survival rates after vaginal and abdominal hysterectomy were 80% and 78% , respectively (P = n.s.). Limiting the analysis to stage I (130 patients), 10- year disease- specific survival was 83% in 95 women operated on by the vaginal route and 84% in 35 patients operated by the abdominal approach (P = n.s.). Patients in the vaginal surgery group had a significantly shorter operative time (P = 0.01), less blood loss (Ptions occurred in 5.4% of the vaginal and in 7.0% of the abdominal procedures. Perioperative mortality was zero after vaginal hysterectomy and 2.3% after abdominal hysterectomy, respectively. Vaginal hysterectomy showed a high cure rate, shorter operative time, less blood loss, reduced morbidity, and no mortality and therefore may be considered the elective approach for treatment of elderly patients with endometrial cancer.

关键词：老年子宫内膜癌经腹子宫切除术阴道手术阴道子宫切除经腹手术长期存活率手术记录临床分期失血量围手术期

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