Fiaccavento Andrea, Landi Stefano, Barbieri Fabrizio, Zaccoletti Riccardo, Tricolore Carlo, Ceccaroni Marcello, Pomini Paola, Bruni Francesco, Soriano David, Stepniewska Ania, Selvaggi Luigi, Zanolla Luisa, Minelli Luca
Obstetrics/Gynecology Department, Ospedale Sacro Cuore Don Calabria, Verona, Italy.
J Minim Invasive Gynecol. 2007 Sep-Oct;14(5):559-63. doi: 10.1016/j.jmig.2007.04.013.
In this review, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uteri weighting more than 500 grams. We compared surgical outcomes and short term follow-up in 149 patients with the uterus weighing less than 350 g (group A: 40-350 g) and 100 patients with the uterus weighing more than 500 g (group B: 500-1550 g). We discovered no statistical difference between the 2 groups in terms of intraoperative complications (group A: 0%; group B: 2%) and postoperative stay (group A: 3.05 +/- 1.89 days; group B: 3.2 +/- 1.28 days). There were statistically significant differences between the 2 groups in terms of operative time (group A: 101.3 +/- 34.3 min; group B: 149.1 +/- 57.2 min.; p <.0001) and postoperative hospital stay length (group A: 2.8 +/- 0.7 days; group B: 3.5 +/- 1.7 days; p <.0001). No major complications occurred in either group. Postoperative minor complications were more frequent in group B (group A: 8.7%; group B: 18%; p = .03). Median time to well-being was comparable in both groups. In conclusion, TLH is a feasible surgical technique also in cases of very large uteri. An increase in operative time, intraoperative blood loss, hospital stay length, and postoperative minor complications can be expected as the uterine weight increases.
在本综述中，我们评估了全腹腔镜子宫切除术（TLH）在子宫重量超过500克的巨大子宫病例中的可行性。我们比较了149例子宫重量小于350克的患者（A组：40 - 350克）和100例子宫重量超过500克的患者（B组：500 - 1550克）的手术结果和短期随访情况。我们发现两组在术中并发症（A组：0%；B组：2%）和术后住院时间（A组：3.05±1.89天；B组：3.2±1.28天）方面无统计学差异。两组在手术时间（A组：101.3±34.3分钟；B组：149.1±57.2分钟；p <.0001）和术后住院天数（A组：2.8±0.7天；B组：3.5±1.7天；p <.0001）方面存在统计学显著差异。两组均未发生重大并发症。B组术后轻微并发症更为常见（A组：8.7%；B组：18%；p = .03）。两组恢复良好的中位时间相当。总之，TLH在巨大子宫病例中也是一种可行的手术技术。随着子宫重量增加，预计手术时间、术中出血量、住院天数和术后轻微并发症会增加。
