腹腔镜次全子宫切除术与全子宫切除术短期结局的比较。

A comparison of short-term outcomes between laparoscopic supracervical and total hysterectomy.

作者信息

Harmanli Ozgur H, Tunitsky Elena, Esin Sertac, Citil Ayse, Knee Alexander

机构信息

Department of Obstetrics and Gynecology, Tufts University School of Medicine, Baystate Medical Center, Springfield, MA, USA.

出版信息

Am J Obstet Gynecol. 2009 Nov;201(5):536.e1-7. doi: 10.1016/j.ajog.2009.07.048.

DOI:10.1016/j.ajog.2009.07.048

PMID:19879396

Abstract

OBJECTIVE

The purpose of this study was to compare perioperative outcome measures of laparoscopic supracervical (LSH) and total hysterectomies (TLH).

STUDY DESIGN

This is a retrospective analysis of 1016 LSHs and TLHs at a tertiary medical center between November 1999 and August 2008 in a multivariate logistic regression model.

RESULTS

Overall, the groups were similar. Most of the perioperative outcome measures did not differ statistically between the groups. However, the risk of serious complications was higher for TLH (5.8% vs 2.5%; odds ratio [OR], 2.72; 95% confidence interval [CI], 1.35-5.49). Specifically, urinary tract injury occurred more frequently in TLH (2.2% vs 0.5%; OR, 4.75; 95% CI, 1.21-18.56). Conversion to laparotomy was significantly more common in TLH (5.8% vs 4.1%; OR, 2.25; 95% CI, 1.20-4.22).

CONCLUSION

In this largest comparison, short-term morbidity of TLH and LSH is overall similar. TLH presents a clinically small, but statistically significant, increased risk of urinary tract injury and conversion to laparotomy.

摘要

目的

本研究旨在比较腹腔镜次全子宫切除术（LSH）和全子宫切除术（TLH）的围手术期结局指标。

研究设计

这是一项对1999年11月至2008年8月在一家三级医疗中心进行的1016例LSH和TLH手术的回顾性分析，采用多因素逻辑回归模型。

结果

总体而言，两组相似。大多数围手术期结局指标在两组间无统计学差异。然而，TLH发生严重并发症的风险更高（5.8%对2.5%；优势比[OR]，2.72；95%置信区间[CI]，1.35 - 5.49）。具体而言，TLH中尿路损伤更频繁发生（2.2%对0.5%；OR，4.75；95%CI，1.21 - 18.56）。TLH中转开腹手术明显更常见（5.8%对4.1%；OR，2.25；95%CI，1.20 - 4.22）。