Cipullo Lucio, De Paoli Sania, Fasolino Luigi, Fasolino Antonio
Department of Obstetrics and Gynaecology, Azienda Ospedaliera Universitaria, Salerno, Italy.
JSLS. 2009 Jul-Sep;13(3):370-5.
The aim of this study was to compare perioperative results of laparoscopic supracervical hysterectomy (LSH) with those of laparoscopic total hysterectomy (TLH).
A retrospective cohort study was conducted at the Department of Gynecology at a teaching hospital. A group of 157 patients who underwent TLH was compared with a group of 157 patients who underwent LSH with or without bilateral salpingo-oophorectomy (BSO). Both groups had similar baseline characteristics and comparable surgical indications.
We reviewed our 7-year experience with laparoscopic hysterectomies performed at our department between October 2000 and November 2007. The similarities between patient characteristics were tested by using Wilcoxon Rank Sum Statistics. Patient and surgery characteristics as well as surgery outcomes were analyzed with descriptive statistics showing medians and 95% CIs. Women who underwent LSH had a shorter operation time compared with women in the TLH group (100 min vs. 110 min). Major complication rates were higher in the TLH group than in the LSH group (4.5% vs. 1.3%). Minor complication rates were 13.3% in the TLH group compared with 13.4% in the LSH group.
Our data and experience provide specific information about the perioperative performance of LSH compared with TLH. In our experience, LSH proved to be a valid alternative to TLH in the absence of specific indications for TLH. Adequate counseling concerning the risk of cyclical bleeding and reoperation is mandatory.
本研究旨在比较腹腔镜次全子宫切除术（LSH）与腹腔镜全子宫切除术（TLH）的围手术期结果。
在一家教学医院的妇科进行了一项回顾性队列研究。将157例行TLH的患者与157例行LSH（伴或不伴双侧输卵管卵巢切除术[BSO]）的患者进行比较。两组患者的基线特征相似，手术指征相当。
我们回顾了2000年10月至2007年11月期间在我院进行腹腔镜子宫切除术的7年经验。使用Wilcoxon秩和统计检验患者特征之间的相似性。采用描述性统计分析患者和手术特征以及手术结果，显示中位数和95%可信区间。与TLH组患者相比，接受LSH的女性手术时间更短（100分钟对110分钟）。TLH组的主要并发症发生率高于LSH组（4.5%对1.3%）。TLH组的轻微并发症发生率为13.3%，而LSH组为13.4%。
我们的数据和经验提供了关于LSH与TLH围手术期表现的具体信息。根据我们的经验，在没有TLH的特定指征时，LSH被证明是TLH的有效替代方法。必须就周期性出血和再次手术的风险提供充分咨询。
