Miyazawa K
Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Obstet Gynecol Surv. 1992 Jul;47(7):433-47. doi: 10.1097/00006254-199207000-00001.
Since the first refined total abdominal hysterectomy was performed by Wilhelm Alexander Freund of Breslau on January 30, 1878, various techniques have been introduced over the past 110 years. Hysterectomy, numbering over 650,000 procedures annually, is the most commonly performed major surgical procedure next to cesarean section in the United States. Although CREOG (Council on Resident Education in Obstetrics and Gynecology) emphasizes the importance of basic pelvic surgical skills and competency in gynecological surgical procedures, cost-effective patient management dictates the shortest hospitalization and most uncomplicated procedure possible. Various techniques of abdominal hysterectomy have been reappraised in view of present-day medical practice concepts. It seems that we are entering a new age wherein a simplified, cost-effective alternative to a classical total abdominal hysterectomy is indeed needed for some cases, and if a hysterectomy is planned, it should be performed in the safest way in the shortest possible operating time for a well-indicated case. Keeping this objective in mind, one Japanese technique of total abdominal hysterectomy and its modification are described with the intent that this will assist Ob/Gyn resident physicians in surgical skill development and also help gynecologists in practice to meet rapidly changing practice patterns of the specialty.
自1878年1月30日布雷斯劳的威廉·亚历山大·弗罗因德实施首例改良式全腹子宫切除术后，在过去的110年里出现了各种手术技术。在美国，子宫切除术每年的手术例数超过65万例，是仅次于剖宫产的最常见的大型外科手术。尽管妇产科住院医师教育委员会（CREOG）强调了基本盆腔手术技能以及妇科手术操作能力的重要性，但具有成本效益的患者管理要求尽可能缩短住院时间并采用最简便的手术方式。鉴于当今的医学实践理念，对各种腹部子宫切除术技术进行了重新评估。看来我们正在进入一个新时代，在某些情况下确实需要一种比传统全腹子宫切除术更简化、更具成本效益的替代方法，并且如果计划进行子宫切除术，对于明确指征的病例，应以最安全的方式在尽可能短的手术时间内完成。牢记这一目标，本文描述了一种日本式全腹子宫切除术技术及其改良方法，旨在帮助妇产科住院医师提高手术技能，也有助于执业妇科医生适应该专业迅速变化的实践模式。
