Morelli M, Caruso M, Noia R, Chiodo D, Cosco C, Lucia E, Biamonte M, Zullo F
Dipartimento di Medicina Sperimentale e Clinica Facoltà di Medicina e Chirurgia, Cattedra di Ginecologia e Ostetricia, Università degli Studi di Catanzaro Magna Graecia, Studi di Catanzaro, Italy.
Minerva Ginecol. 2007 Apr;59(2):99-105.
The aim of the study was to compare the effects of total laparoscopic hysterectomy with those of vaginal hysterectomy.
We conducted a prospective randomised trial on 400 patients who agreed to be randomized to either laparoscopic total hysterectomy or vaginal hysterectomy. They were monitored for one year to evaluate the rate of major complications and the results on quality of life.
Total laparoscopic hysterectomy was associated with a higher rate of major haemorrhages and ureteric injuries than vaginal hysterectomy (7% vs 2.5% and 2.5% vs 0%; P<0.05) only during the first year of study according to a normal learning-curve. It took longer to perform (85.9 min vs 46.6 min), but was less painful (visual analogue scale 5.3 vs 6.0; P<0.01) and there was a shorter stay in hospital after the operation (2.9 vs 3.3 days). Six weeks after the operation, total laparoscopic hysterectomy was associated with less pain and better quality of life than vaginal hysterectomy (SF-12).
Total laparoscopic hysterectomy was associated with a significantly higher rate of major haemorrhages and ureteric injuries than vaginal hysterectomy only during the first year of study according to a normal learning-curve. It took longer to perform but was associated with less pain, quicker recovery, and better short term quality of life.
本研究旨在比较全腹腔镜子宫切除术与经阴道子宫切除术的效果。
我们对400例同意随机接受腹腔镜全子宫切除术或经阴道子宫切除术的患者进行了一项前瞻性随机试验。对她们进行了一年的监测，以评估主要并发症的发生率以及生活质量结果。
根据正常学习曲线，仅在研究的第一年，全腹腔镜子宫切除术与经阴道子宫切除术相比，主要出血和输尿管损伤的发生率更高（分别为7%对2.5%和2.5%对0%；P<0.05）。其手术时间更长（85.9分钟对46.6分钟），但疼痛较轻（视觉模拟评分5.3对6.0；P<0.01），术后住院时间更短（2.9天对3.3天）。术后六周，全腹腔镜子宫切除术与经阴道子宫切除术相比，疼痛较轻，生活质量更好（SF-12）。
根据正常学习曲线，仅在研究的第一年，全腹腔镜子宫切除术与经阴道子宫切除术相比，主要出血和输尿管损伤的发生率显著更高。其手术时间更长，但疼痛较轻，恢复更快，短期生活质量更好。
Zotero 插件