Hong Dae G, Seong Won J, Lee Yoon S, Cho Young L
Department of Obstetrics and Gynecology, Kyungpook National University Graduate School of Medicine, Daegu, Korea.
Minim Invasive Ther Allied Technol. 2009;18(6):317-21. doi: 10.3109/13645700903201340.
The study analyzes factors that affect vaginal hysterectomy to establish the indications of a vaginal approach to benign uterine disease. In a retrospective study, 174 patients underwent vaginal hysterectomy for uterine leiomyomas or adenomyosis by one gynecologist between December 2005 and December 2006. All data were compared and analyzed by X(2)- test, t-test, and multiple logistic regression. Based on a uterine weight > or = 500 g, body weight, a history of surgery, concomitant surgery (adenexectomy), penetration of the posterior cul de sac during surgery, uterine descent, and average uterine weight we determined the feasibility of vaginal hysterectomy. Based on an operative time > or = 33 min, body weight, concomitant surgery (adenexectomy), penetration of the posterior cul de sac, vertical length of the vaginal opening, uterine descent, and the uterine weight had significant effects on the success of vaginal hysterectomy. The range of indications for vaginal hysterectomy may vary greatly depending on the surgeon's experience. If experiences are accumulated gradually, together with the advantages of laparoscopically assisted hysterectomy, most abdominal hysterectomies and laparoscopic hysterectomies can be replaced by vaginal hysterectomy.
本研究分析影响阴式子宫切除术的因素，以确立阴式手术治疗良性子宫疾病的适应证。在一项回顾性研究中，2005年12月至2006年12月间，一名妇科医生为174例子宫平滑肌瘤或子宫腺肌病患者实施了阴式子宫切除术。所有数据采用X²检验、t检验及多元逻辑回归进行比较和分析。根据子宫重量≥500g、体重、手术史、同期手术（附件切除术）、术中后穹窿穿透情况、子宫脱垂情况及平均子宫重量，我们确定了阴式子宫切除术的可行性。根据手术时间≥33分钟、体重、同期手术（附件切除术）、后穹窿穿透情况、阴道口垂直长度、子宫脱垂情况及子宫重量，这些因素对阴式子宫切除术的成功有显著影响。阴式子宫切除术的适应证范围可能因手术医生的经验不同而有很大差异。如果经验逐步积累，再结合腹腔镜辅助子宫切除术的优点，大多数腹式子宫切除术和腹腔镜子宫切除术可被阴式子宫切除术所取代。
