Analysis of 68 cases of uterine preservation surgery performed again after removing adenomyosis lesions in an external hospital
在外院手术挖除腺肌症病灶后再次做保宫U手术68例分析

摘要

目的 探讨外院行传统腺肌症病灶挖除术后复发的弥漫性子宫腺肌症患者再次行王斌教授发明的子宫肌层U形挖除保宫手术（以下简称保宫U手术）的临床疗效，并与首次行保宫U手术的患者进行对比分析，为弥漫性子宫腺肌症的临床治疗提供参考依据。方法 选取2024年7月-2025年12月本院收治的68例外院行传统病灶挖除术后复发的弥漫性子宫腺肌症患者作为研究组，均行保宫U手术治疗；选取同期本院收治的50例首次行保宫U手术的弥漫性子宫腺肌症患者作为对照组。对比两组患者的手术时间、术中出血量、术后排气时间及术后住院时间等临床指标。结果 研究组平均手术时间、术中出血量、术后排气时间及术后住院时间均显著高于对照组，组间比较差异具有统计学意义（P＜0.01）。所有患者保宫U手术后均未进行后续药物治疗，随访期间未出现明显手术相关并发症。结论 外院传统腺肌症病灶挖除术因术式局限难以彻底清除病灶，导致术后高复发率，且复发病例再次行保宫U手术的难度更大、临床手术指标较首次手术患者更差；王斌教授发明的保宫U手术可实现弥漫性子宫腺肌症病灶的彻底清除，是保留子宫治疗弥漫性子宫腺肌症的优选术式，临床应重视手术方式与手术医生的选择。

Abstract

Objective To investigate the clinical efficacy of Professor Wang Bin's U-shaped uterine muscle layer removal and uterine preservation surgery (hereinafter referred to as uterine preservation U surgery) for recurrent diffuse adenomyosis patients who underwent traditional adenomyosis lesion removal surgery in external hospitals, and to compare and analyze it with patients who underwent uterine preservation U surgery for the first time, providing reference for the clinical treatment of diffuse adenomyosis.
Methods A total of 68 patients with diffuse adenomyosis who underwent traditional lesion excision surgery and relapsed after treatment in external hospital from July 2024 to December 2025 were selected as the study group, all of whom underwent uterine preservation surgery; Select 50 patients with diffuse adenomyosis who underwent first-time uterine preservation surgery in our hospital during the same period as the control group. Compare clinical indicators such as surgical time, intraoperative blood loss, postoperative exhaust time, and postoperative hospital stay between two groups of patients.
Results The average surgical time, intraoperative blood loss, postoperative exhaust time, and postoperative hospital stay in the study group were significantly higher than those in the control group, and the differences between the groups were statistically significant (P<0.01). All patients did not receive follow-up medication treatment after the uterine protection surgery, and no significant surgical related complications were observed during the follow-up period.
Conclusion   Traditional adenomyosis lesion removal surgery in external hospitals is difficult to completely remove lesions due to limited surgical procedures, resulting in a high recurrence rate after surgery. In addition, recurrent cases are more difficult to undergo uterine preservation surgery again, and clinical surgical indicators are worse than those of first-time surgery patients; The uterine preservation U surgery invented by Professor Wang Bin can achieve complete removal of diffuse adenomyosis lesions, and is the preferred surgical method for preserving the uterus to treat diffuse adenomyosis. Clinical attention should be paid to the choice of surgical method and surgeon.