Bai Wen-pei, Li Li-ping, Feng Mei-ying, Wang Xiu-hua, Qin Xiao-qi, Li Ke-Min, Zhou Ying-fang
Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
Zhonghua Fu Chan Ke Za Zhi. 2005 Oct;40(10):656-8.
To compare the clinical characteristics of transvaginal hysterectomy (TVH) and total laparoscopic hysterectomy (TLH).
Clinical data about 301 cases who received TVH and TLH were collected and the hospital stay days, medical expenses, diagnoses, operation and recovery status were compared between TVH and TLH groups.
The ratio of cervical atypical hyperplasia (9.64%), multipara (96.45%) in TVH was higher than that in TLH (2.88%, 89.42%). The ratio of adenoma (29.44%), adnexal disease (4.55%), pelvic endometriosis (4.06%), history of cesarean section (7.11%) in TVH were lower than that in TLH (43.27%, 31.73%, 12.50%, 24.04%). The operation time (76 +/- 28) minutes, bleeding during operation (170 +/- 125) ml, additional operations (5.08%), pelvic adhesion (4.57%), loosening of pelvic adhesion (0.51%), the diameter of the largest myoma or adenoma (49 +/- 17) mm, expenses for operation and hospitalization (1073 +/- 203) yuan in TVH were lower than those in TLH, which were (139 +/- 52) minutes, (206 +/- 153) ml, 36.54%, 41.35%, 17.31%, (57 +/- 22) mm, (1526 +/- 676) yuan respectively. The differences were significant (all P < 0.05). There was no difference of the uterine weight, complication and length of hospitalization duration between the two kinds of operation.
TVH is recommended in cases of few pelvic adhesion, or adnexal disease, cervical disease and of multipara. The uterine weight is not a decisive factor.
比较经阴道子宫切除术(TVH)和全腹腔镜子宫切除术(TLH)的临床特征。
收集301例行TVH和TLH患者的临床资料,比较两组患者的住院天数、医疗费用、诊断情况、手术及恢复状况。
TVH组宫颈非典型增生比例(9.64%)、经产妇比例(96.45%)高于TLH组(2.88%,89.42%)。TVH组腺瘤比例(29.44%)、附件疾病比例(4.55%)、盆腔子宫内膜异位症比例(4.06%)、剖宫产史比例(7.11%)低于TLH组(43.27%,31.73%,12.50%,24.04%)。TVH组手术时间(76±28)分钟、术中出血量(170±125)毫升、附加手术比例(5.08%)、盆腔粘连比例(4.57%)、盆腔粘连松解比例(0.51%)、最大肌瘤或腺瘤直径(49±17)毫米、手术及住院费用(1073±203)元低于TLH组,分别为(139±52)分钟、(206±153)毫升、36.54%、41.35%、17.31%、(57±22)毫米、(1526±676)元。差异有统计学意义(均P<0.05)。两种手术方式的子宫重量、并发症及住院时间差异无统计学意义。
盆腔粘连少、无附件疾病、宫颈疾病及经产妇建议行TVH。子宫重量不是决定性因素。