Gitsch G, Berger E, Tatra G
Second Department of Obstetrics and Gynecology, University of Vienna Medical School, Austria.
Arch Gynecol Obstet. 1991;249(4):209-12. doi: 10.1007/BF02390389.
Vaginal hysterectomy is less invasive than hysterectomy performed via the abdominal approach. The vaginal approach may be made difficult by prior conisation, a need to remove the adnexae or marked uterine enlargement requiring morcellement. In this retrospective study we have investigated the impact of these factors on the incidence of complications in 1912 patients subject to vaginal hysterectomy. We have studied the incidence of intraoperative hemorrhage, bladder damage, hemorrhage up to 48 h after surgery, hemorrhage up to 14 days after surgery, vault abscesses or collections and pelvic peritonitis. In patients with prior morcellement, intraoperative hemorrhage was significantly more frequent. All other complications were not significantly increased by the intraoperative difficulties specified above. Thus even "difficult" vaginal hysterectomy would seem to carry low morbidity.
阴式子宫切除术的创伤性小于经腹子宫切除术。先前的锥形切除术、切除附件的需求或因子宫显著增大而需要碎解术可能会使阴式手术变得困难。在这项回顾性研究中，我们调查了这些因素对1912例行阴式子宫切除术患者并发症发生率的影响。我们研究了术中出血、膀胱损伤、术后48小时内出血、术后14天内出血、穹窿脓肿或积液以及盆腔腹膜炎的发生率。在先前有碎解术的患者中，术中出血明显更频繁。上述术中困难并未使所有其他并发症显著增加。因此，即使是“困难的”阴式子宫切除术似乎发病率也较低。
