Morrison John E, Jacobs Volker R
Department of Surgery, Fayette Medical Center (FMC), Fayette, Alabama, USA.
JSLS. 2006 Jan-Mar;10(1):26-9.
We report and review herein our 10-year experience with classic intrafascial supracervical hysterectomy focusing on our long-term experience, evolution of the operative technique, and increased use of this technique.
We performed a parallel, observational study with retrospective data to evaluate classic intrafascial supracervical hysterectomy, a laparoscopic hysterectomy technique, at Fayette Medical Center, a community hospital in Northwestern Alabama, USA. Patients comprised a consecutive series of 579 over a 10-year period from November 1992 through November 2002.
The classic intrafascial supracervical hysterectomy technique, similar to standard supracervical hysterectomy, leaves the cardinal ligament, uterosacral ligament, vascular supply, and innervation to the upper vagina and cervix intact, but unlike supracervical hysterectomy removes the transition zone and endocervical canal. For 579 patients, the average age was 45.4 years (range, 22 to 92), follow-up was 75.3 months (range, 17 to 137), operating room time was 69 minutes (range, 44 to 370), blood loss was 72 mL (range, 10 to 765), length of hospital stay was 23.2 hours (range, 14 hours to 5 days), time to return to work was 13.2 days (range, 3 to 28). Complications include 11 cervical bleedings, 1 uterine artery bleeding, 1 pelvic hematoma, 1 postoperative ileus, and 16 mucoceles of the cervical stump. Three patients were converted from a laparoscopic to an open procedure (0.52%). Long-term follow-up of up to 137 months shows no adverse events thus far.
Classic intrafascial supracervical hysterectomy is a safe procedure with a low short- and long-term complication rate. It has a short recuperation period and high patient satisfaction. It is the procedure of choice when hysterectomy is indicated for benign disease.
本文报告并回顾了我们在经典筋膜内子宫次全切除术中的10年经验，重点关注我们的长期经验、手术技术的演变以及该技术使用的增加情况。
我们在美国阿拉巴马州西北部的一家社区医院费耶特医疗中心进行了一项平行的观察性研究，利用回顾性数据评估经典筋膜内子宫次全切除术（一种腹腔镜子宫切除术技术）。患者为1992年11月至2002年11月这10年间连续收治的579例患者。
经典筋膜内子宫次全切除术技术与标准子宫次全切除术类似，保留了主韧带、子宫骶骨韧带、血管供应以及阴道上段和宫颈的神经支配，但与子宫次全切除术不同的是，它切除了移行带和子宫颈管。579例患者的平均年龄为45.4岁（范围22至92岁），随访时间为75.3个月（范围17至137个月），手术时间为69分钟（范围44至370分钟），失血量为72毫升（范围10至765毫升），住院时间为23.2小时（范围14小时至5天），恢复工作时间为13.2天（范围3至28天）。并发症包括11例宫颈出血、1例子宫动脉出血、1例盆腔血肿、1例术后肠梗阻以及16例宫颈残端黏液囊肿。3例患者由腹腔镜手术转为开腹手术（0.52%）。长达137个月的长期随访显示，目前尚无不良事件发生。
经典筋膜内子宫次全切除术是一种安全的手术，短期和长期并发症发生率低。它的康复期短，患者满意度高。当因良性疾病需要进行子宫切除术时，它是首选的手术方式。
