Study on minimally invasive u-shaped resection of diffuse adenomyosis lesions via cosmetic small incision in the lower abdomen for preservation of uterine and reproductive function
下腹部美容小切口微创U形挖除弥漫性子宫腺肌症病灶保留子宫生育功能的研究

摘要

目的 探索下腹部美容小切口微创U形挖除弥漫性子宫腺肌症病灶的临床效果，实现保留子宫及生育功能的目标。方法 选取38例有生育需求的弥漫性子宫腺肌症患者，采用全麻下小切口入路，宫腔置入输卵管导丝后U形挖除病灶，缝合子宫并放置宫腔扩张器，术后随访评估。结果 38例手术均顺利完成，平均手术时间66分钟，术中出血100-200mL，术后痛经显著缓解，CA125及子宫体积恢复正常，1年输卵管通畅率65.79%，无复发。结论 该术式创伤小、恢复快，可有效挖除病灶并保留生育功能，为年轻有生育需求的弥漫性子宫腺肌症患者提供安全可行的治疗方案。

Abstract

Objective To explore the clinical efficacy of minimally invasive U-shaped resection of diffuse adenomyosis lesions via a cosmetic small incision in the lower abdomen, aiming to preserve the uterus and reproductive function.
Methods Thirty-eight patients with diffuse adenomyosis and fertility requirements were selected. A small incision approach under general anesthesia was adopted. After inserting a fallopian tube guide wire into the uterine cavity, U-shaped resection of lesions was performed, followed by uterine suture and placement of an intrauterine dilator. Postoperative follow-up and evaluation were conducted.
Results All 38 surgeries were successfully completed with a mean operation time of 66 minutes and intraoperative blood loss of 100-200ml. Postoperative dysmenorrhea was significantly relieved, CA125 levels and uterine volume returned to normal, the fallopian tube patency rate was 65.79% at 1 year, and no recurrence was observed.
Conclusion   This surgical method has the advantages of minimal trauma and rapid recovery. It can effectively resect lesions and preserve reproductive function, providing a safe and feasible treatment option for young patients with diffuse adenomyosis who have fertility needs.