Rong Chun-hong, Shen Keng, Lang Jing-he, Yang Jia-xin, Wu Ming, Pan Ling-ya, Leng Jin-hua
Department of Obstetrics and Gynecology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2007 Jun;29(3):418-21.
To compare the clinical characteristics of three subcategories of laparoscopic hysterectomy: total laparoscopic hysterectomy (TLH) and two subcategories of laparoscopic-assisted vaginal hysterectomy (LAVH): LAVHs and LAVHb.
We retrospectively analyzed the clinical data of 393 patients underwent laparoscopic hysterectomy, including TLH (n=178), LAVHa (n=177), and LAVHb (n=38), in our hospital from September 2002 to September 2005.
Myoma and adenomyosis of uterus were the most common diseases in this study, accounting for 66.9%, 38.4%, and 52.6% in TLH group, LAVHa group, and LAVHb group, respectively. The mean surgery duration and blood loss were not significantly different between TLH group and LAVHa group (P > 0.05), but were significantly less in TLH group than in LAVHb group (P < 0.05). The bulk of uterus in TLH group was significantly bigger than in other two groups (P < 0.05). The incidence of major complications in the TLH group (9. 0%) was lower than in LAVHa group (14.1%) and in LAVHb group (18.4%), but without statistical significance. Conclusion Compared with LAVH, TLH is feasible to deal with bigger uterus with less blood loss and shorter surgery duration and without more frequent complications.
比较腹腔镜子宫切除术的三个亚类的临床特征:全腹腔镜子宫切除术(TLH)以及腹腔镜辅助阴道子宫切除术(LAVH)的两个亚类:LAVHa和LAVHb。
我们回顾性分析了2002年9月至2005年9月在我院接受腹腔镜子宫切除术的393例患者的临床资料,包括TLH(n = 178)、LAVHa(n = 177)和LAVHb(n = 38)。
子宫肌瘤和子宫腺肌病是本研究中最常见的疾病,分别占TLH组、LAVHa组和LAVHb组的66.9%、38.4%和52.6%。TLH组和LAVHa组之间的平均手术时间和失血量无显著差异(P>0.05),但TLH组明显少于LAVHb组(P<0.05)。TLH组子宫体积明显大于其他两组(P<0.05)。TLH组主要并发症发生率(9.0%)低于LAVHa组(14.1%)和LAVHb组(18.4%),但无统计学意义。结论与LAVH相比,TLH对于处理较大子宫是可行的,具有较少的失血量和较短的手术时间,且并发症发生率不会更高。