Iftikhar Razia
Department of Obstetrics & Gynaecology, Jinnah Medical & Dental College and Hospital, Karachi.
J Coll Physicians Surg Pak. 2005 Oct;15(10):594-6.
To determine the outcome of subtotal abdominal hysterectomy in terms of intraoperative and postoperative complications in women with benign uterine conditions.
Descriptive study.
The Jinnah Medical and Dental College and Hospital, Karachi from March, 2003 to March, 2004.
The study included 50 women, who underwent subtotal abdominal hysterectomy due to technical difficulties during surgery in benign uterine diseases. Inclusion criteria were menorrhagia and pelvic pain, dysfunctional uterine bleeding, repeated pelvic infection refractory to medical treatment, fibroid uterus and ovarian cyst with adenomyosis of uterus. Patients over 60 years of age, uterine prolapse and suspected cancer of cervix were excluded. Detailed history was taken and examination done. Routine investigations including ultrasound were carried out. Subtotal hysterectomy was performed by clamp-cut and ligate method.
The mean age of patients undergoing hysterectomy was 44 years and parity between 4 - 10. Most common complaint was excessive menstrual loss. Fibroid was found in 10 (20%) cases, dysfuntional uterine bleeding in 15 (30%), pelvic pain and menorrhagia in 5 (10%), ovarian cyst with adenomyosis in 13 (26%) and repeated pelvic infections refractory to medical treatment in 7 (14%).There was no injury to adjacent vicera during the procedure. Early complications like temperature was noted in 5 (10%) and late complications like cyclical menstrual bleeding in 1 (2%) and vaginal discharge in 2 (4%) patients. All cases were followed-up 3 and 6 monthly and urinary, sexual and bowel functions were found to be unaffected during this period. There was no mortality associated with the procedure. The histopathology of specimen revealed fibroid followed by adenomyosis to be the commonest pathology.
Subtotal abdominal hysterectomy resulted in less operative time, rapid recovery, fewer short-term complications but infrequently caused cyclical bleeding and vaginal discharge.
根据患有良性子宫疾病女性的术中及术后并发症情况，确定腹式子宫次全切除术的结果。
描述性研究。
2003年3月至2004年3月，卡拉奇真纳医学与牙科学院及医院。
该研究纳入50名女性，她们因良性子宫疾病手术中存在技术困难而接受腹式子宫次全切除术。纳入标准为月经过多和盆腔疼痛、功能性子宫出血、药物治疗无效的反复盆腔感染、子宫肌瘤以及合并子宫腺肌病的卵巢囊肿。排除60岁以上患者、子宫脱垂及疑似宫颈癌患者。记录详细病史并进行检查。进行包括超声在内的常规检查。采用钳夹-切断-结扎法实施子宫次全切除术。
接受子宫切除术患者的平均年龄为44岁，产次在4至10次之间。最常见的主诉是月经量过多。10例（20%）发现子宫肌瘤，15例（30%）为功能性子宫出血，5例（10%）为盆腔疼痛和月经过多，13例（26%）为合并子宫腺肌病的卵巢囊肿，7例（14%）为药物治疗无效的反复盆腔感染。手术过程中未对相邻脏器造成损伤。5例（10%）出现发热等早期并发症，1例（2%）出现周期性月经出血、2例（4%）出现阴道分泌物等晚期并发症。所有病例每3个月和6个月进行随访，在此期间发现泌尿、性和肠道功能未受影响。该手术无死亡病例。标本的组织病理学显示，最常见的病理是子宫肌瘤，其次是子宫腺肌病。
腹式子宫次全切除术手术时间较短、恢复快、短期并发症较少，但偶尔会引起周期性出血和阴道分泌物。
