Pan Hun-Shan, Ko Ma-Lee, Huang Lee-Wen, Chang Jier-Zen, Hwang Jiann-Loung, Chen Su-Chee
Department of Obstetrics and Gynecology, Shin-Kong Memorial Hospital, Taipei, Taiwan.
Minim Invasive Ther Allied Technol. 2008;17(5):318-22. doi: 10.1080/13645700802274588.
We tried to evaluate the relative feasibility, surgical duration and complications of total laparoscopic hysterectomy (TLH) versus coagulation of uterine arteries at their origin (CUA) plus total laparoscopic hysterectomy for the management of myoma and adenomyosis, and to compare the estimated blood loss for both procedures. A total of 123 patients underwent TLH or CUA plus TLH for the treatment of symptomatic myoma and adenomyosis. Sixty-four women underwent TLH, whilst 68 women underwent coagulation of uterine arteries at their origin plus TLH. The mean weight and volume of the uterus as determined following TLH was 288.1+/-102.4 gm (range 182.1 approximately 396.2 gm.) and 451+/-340.6 cm(3) (range 107.4 approximately 792), respectively. The mean weight of the uterus following CUA plus TLH was 269.1+/-151.7 gm (range 215.8 approximately 430.1) whilst the mean uterine volume was 472.7+/-377.8 cm(3) (range 93.7 approximately 851.2). No significant differences with respect to surgical duration (95 vs. 96.5 minutes TLH vs. CUA + TLH; p>0.05), blood loss (177.2+/-80.1 ml for TLH and 154.9+/-30.21 ml for CUA+TLH; p>0.05) and mean+/-SD preoperative (12.05+/-1.70 gm/dl for TLH and 12.14+/-1.38 gm/dl for CUA+TLH; p>0.05) and post-operative hemoglobin level (11+/-1.03 for TLH and 11+/-1.49 for CUA + TLH; p>0.05) were observed between the two study groups. The blood loss for TLH is comparable to that for the CUA plus TLH procedure.
我们试图评估全腹腔镜子宫切除术（TLH）与子宫动脉起始部凝固术（CUA）加全腹腔镜子宫切除术治疗肌瘤和子宫腺肌病的相对可行性、手术时长及并发症，并比较两种手术的估计失血量。共有123例患者接受了TLH或CUA加TLH治疗有症状的肌瘤和子宫腺肌病。64例女性接受了TLH，而68例女性接受了子宫动脉起始部凝固术加TLH。TLH术后测定的子宫平均重量和体积分别为288.1±102.4克（范围182.1至约396.2克）和451±340.6立方厘米（范围107.4至约792）。CUA加TLH术后子宫平均重量为269.1±151.7克（范围215.8至约430.1），而子宫平均体积为472.7±377.8立方厘米（范围93.7至约851.2）。两个研究组在手术时长（TLH为95分钟，CUA + TLH为96.5分钟；p>0.05）、失血量（TLH为177.2±80.1毫升，CUA + TLH为154.9±30.21毫升；p>0.05）以及术前平均±标准差血红蛋白水平（TLH为12.05±1.70克/分升，CUA + TLH为12.14±1.38克/分升；p>0.05）和术后血红蛋白水平（TLH为11±1.03，CUA + TLH为11±1.49；p>0.05）方面均未观察到显著差异。TLH的失血量与CUA加TLH手术的失血量相当。
