저자 등은 1996년 1월부터 1997년 12월까지 복강경하 자궁근종절제술을 시행 받은 10명의 환자를 대상으로 임상 결과를 분석하고 문헌 고찰을 하였다. 본 연구에서는 다른 복강경하 자궁근종절제술에 관한 연구에 비하여 수술시의 출혈이 많았으며, 이는 근종 주변의 자궁근에 혈관수축제를 사용하지 않은 것과 지혈에 비효율적인 단극성 전류를 주로 사용한 것에 기인한다고 분석하였다. 결론적으로 적절히 환자를 선택하고 양극성 전기 소 작기를 구비한 상태에서 숙련된 복강경 시술자가 수술 원칙을 준수할 때만 효과적인 복강경하 근종절제술이 이루어 질 것으로 사료되며 수술중 및 수술후 출혈, 유착 의 발생 및 향후 가임력의 향상 등에 관하여는 계속적인 연구가 요망된다고 하겠다.

Traditionally, the myomectomy has been performed via laparotomy and there have been some reports that laparoscopic myomectomy has advantages of reduced intra-and postoperative morbidity, shorter hospital stay and recovery time, earlier return to normal activities, fewer postoperative adhesions and better cosmetic scars as compared with traditional abdominal myomectomy. However, the disadvantages of the laparoscopic myomectomy include increased operating time, inability to palpate the uterus during operation, and the requirement of advanced technical skills. Actually the role of laparoscopic myomectomy remains controversial until now. We experienced 33 cases of laparoscopic myomectomy from January 1996 to December 1997, but most of them were performed ancillarily during other operations for ovarian tumors, pelvic endometriosis, tubal pregnancies, etc. Among 33 patients, ten received laparoscopic myomectomy as a major procedure. We present clinical characteristics of these patients and laparoscopic procedures we performed. The average age of patients was 36.0±7.0 (mean±S.D.) years and the mean parity was 1.3 (±1.2). The myomas were subserosal type in 5 cases, intramural type in 4 cases and intraligamentary type in one. The maximal diameter of the myomas ranged from 1.5 to 7.5 cm and the mean diameter was 5.2 (±1.6) cm. Seven cases had only one myoma, but 3 cases had two or more. The operation time ranged from 65 to 200 minutes (mean: 121.5±46.4) and average hemoglobin change(preoperative- postoperative hemoglobin) was 2.5 (±1.2) g/dl. There was no intraoperative and postoperative complication except one case of trocar site hemorrhage. In conclusion, the laparoscopic procedure is effective for myomectomy, but it is essential to adhere to the basic surgical principles to optimize its safety and efficacy. However, its advantages are still needed to be established based on long term outcomes.