Ostrzenski A
Department of Obstetrics and Gynecology, Howard University College of Medicine and Hospital, Washington, D.C., USA.
J Reprod Med. 1999 Oct;44(10):853-8.
To establish the consecutive steps in and evaluate the safety and effectiveness of laparoscopic total abdominal hysterectomy (L-TAH) (hysterectomy completed via laparoscopy, with no transvaginal approach by the suturing technique) in a group of morbidly obese women and to compare the results to a group of nonobese women with clinically similar characteristics and indications for hysterectomy.
Eleven morbidly obese women were subjected to a L-TAH with no vaginal approach. The operation was executed by suturing and tying an extracorporeal sliding knot and by using intracorporeal two-turn flat square knot methods. The consecutive steps of the operation were changed from the original to facilitate this procedure. The group of morbidly obese women was compared to a group of nonobese women.
All the subjects exceeded their ideal body weight by 100%. Their actual weight ranged from 118.9 to 139.8 kg, and their height ranged from 58 to 69 in. All the planned surgery was completed, and no intraoperative or postoperative complications were observed. There was no conversion from the laparoscopic approach to a laparotomy or transvaginal path. When compared to that in the control group, the mean operating time was significantly longer in morbidly obese subjects.
L-TAH is safe and effective for morbidly obese women.
确定一组病态肥胖女性行腹腔镜全腹子宫切除术（L-TAH，即通过腹腔镜完成子宫切除术，不采用经阴道缝合技术）的连续步骤，并评估其安全性和有效性，同时将结果与一组具有临床相似特征和子宫切除指征的非肥胖女性进行比较。
11名病态肥胖女性接受了无阴道入路的L-TAH手术。手术通过体外滑动结缝合和体内双圈扁平方结方法进行。手术的连续步骤与原来不同，以方便该手术操作。将病态肥胖女性组与非肥胖女性组进行比较。
所有受试者的体重超过理想体重100%。她们的实际体重在118.9至139.8千克之间，身高在58至69英寸之间。所有计划的手术均完成，未观察到术中或术后并发症。没有从腹腔镜入路转为剖腹手术或经阴道手术。与对照组相比，病态肥胖受试者的平均手术时间明显更长。
L-TAH对病态肥胖女性是安全有效的。
