Aniuliene Rosita, Varzgaliene Laima, Varzgalis Manvydas
Department of Obstetrics and Gynecology, Kaunas University of Medicine, Kaunas, Lithuania.
Medicina (Kaunas). 2007;43(2):118-24.
The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital.
A retrospective review of medical histories was performed for women who had undergone three different types of hysterectomies (laparoscopic, vaginal, and abdominal) at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital during 2004-2005.
A total of 602 hysterectomies were performed: 51 (8.5%) laparoscopic, 203 (33.7%) vaginal, and 348 (57.8%) abdominal. The lowest complication rate occurred in patients who underwent laparoscopic hysterectomy (n=5, 9.8%) and the highest--abdominal hysterectomy (n=88, 25.2%) (P<0.05). More complication occurred after abdominal as compared to vaginal hysterectomy (n=88, 25.2% vs. n=20, 9.9%, respectively; P<0.05). There was no statistically significant difference in complication rate comparing laparoscopic and vaginal hysterectomies (P=0.26). The amount of blood loss depended on the type of hysterectomy--less blood was lost during laparoscopic and more during abdominal hysterectomy (123.4 vs. 308.5 mL, respectively; P<0.01). A significantly higher blood loss was observed during abdominal hysterectomy as compared to vaginal (195.3 mL) and vaginal as compared to laparoscopic hysterectomy (P<0.01). The mean length of hospital stay differed comparing all three types of hysterectomies: the shortest stay of 8.6 days was after laparoscopic, the longest of 13.7 days--after abdominal hysterectomy. The mean hospital stay was statistically significant shorter for vaginal hysterectomy compared to abdominal hysterectomy (9.1 vs. 13.7 days, P<0.01). The difference in mean length of hospital stay was insignificant comparing laparoscopic and vaginal hysterectomies (P>0.05).
Abdominal hysterectomy was the most common procedure performed. The type of hysterectomy influenced the rate of complications--the lowest complication rate was after laparoscopic and vaginal hysterectomies. The amount of blood loss depended on the type of hysterectomy--the lowest was during laparoscopic hysterectomy. Abdominal hysterectomy required on average a longer hospital stay compared with laparoscopic and vaginal hysterectomies.
本研究的目的是评估和比较在考纳斯医科大学医院妇产科进行的腹腔镜子宫切除术、阴道子宫切除术和腹部子宫切除术的手术及术后结果和差异。
对2004年至2005年期间在考纳斯医科大学医院妇产科接受三种不同类型子宫切除术（腹腔镜、阴道和腹部）的女性患者的病历进行回顾性研究。
共进行了602例子宫切除术：51例（8.5%）腹腔镜手术、203例（33.7%）阴道手术和348例（57.8%）腹部手术。接受腹腔镜子宫切除术的患者并发症发生率最低（n = 5，9.8%），腹部子宫切除术患者并发症发生率最高（n = 88，25.2%）（P < 0.05）。与阴道子宫切除术相比，腹部子宫切除术后并发症更多（分别为n = 88，25.2%和n = 20，9.9%；P < 0.05）。腹腔镜子宫切除术和阴道子宫切除术的并发症发生率无统计学显著差异（P = 0.26）。失血量取决于子宫切除术的类型——腹腔镜手术中失血量较少，腹部手术中失血量较多（分别为123.4 mL和308.5 mL；P < 0.01）。与阴道子宫切除术（195.3 mL）相比，腹部子宫切除术中观察到的失血量显著更高，与腹腔镜子宫切除术相比，阴道手术中的失血量也更高（P < 0.01）。比较所有三种类型的子宫切除术，平均住院时间不同：腹腔镜手术后住院时间最短，为8.6天，腹部子宫切除术后最长，为13.7天。与腹部子宫切除术相比，阴道子宫切除术的平均住院时间在统计学上显著更短（9.1天对13.7天，P < 0.01）。腹腔镜子宫切除术和阴道子宫切除术的平均住院时间差异不显著（P > 0.05）。
腹部子宫切除术是最常见的手术方式。子宫切除术的类型影响并发症发生率——腹腔镜和阴道子宫切除术后并发症发生率最低。失血量取决于子宫切除术的类型——腹腔镜子宫切除术中失血量最少。与腹腔镜和阴道子宫切除术相比，腹部子宫切除术平均需要更长的住院时间。
