子宫黏膜下肌瘤因其特殊的生长部位,更易影响女性的月经生理和妊娠分娩,是促使育龄期女性求医问药的主要妇科疾病。随着内镜技术的发展,宫腔镜子宫肌瘤切除术(transcervical resection of myoma,TCRM)已经取代传统开腹及腹腔镜手术,成为治疗子宫黏膜下肌瘤的标准术式。全面认识黏膜下子宫肌瘤,准确掌握TCRM手术适应证、围手术期处理原则以及手术技巧是保证手术安全、成功的关键。文章结合文献围绕黏膜下肌瘤分类、TCRM手术指征及围手术期准备、手术步骤与技巧、手术效果以及手术注意事项进行论述。 Uterine submucosal fibroids because of its special growth site, more likely to affect women’s menstrual physiology and pregnancy and childbirth, is to promote women of childbearing age seeking medical treatment of major gynecological diseases. With the development of endoscopic technology, transcervical resection of myoma (TCRM) has replaced the traditional open laparoscopic and laparoscopic surgery, a standard surgical treatment of uterine submucous myoma. Comprehensive understanding of submucosal uterine fibroids, accurate identification of TCRM indications, perioperative management principles and surgical techniques is to ensure the safety of surgery, the key to success. This article discusses the classification of submucosal fibroids, TCRM indications and perioperative preparation, surgical procedures and techniques, surgical effects and surgical precautions.