Department of Obstetrics and Gynecology, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, Korea.
Arch Gynecol Obstet. 2010 Dec;282(6):631-8. doi: 10.1007/s00404-009-1300-0. Epub 2009 Nov 27.
We compared the incidence of vaginal cuff dehiscence and other surgical complications after different modes of suturing during total laparoscopic hysterectomy (TLH), and reviewed the characteristics of patients with complications.
We enrolled 248 patients undergoing TLH for benign diseases at Daejeon St Mary's Hospital of Korea from March 2007 through February 2009. We evaluated the clinical outcomes of different vaginal cuff suture techniques during TLH: the widely used interrupted figure-of-eight suture and a two-layer running suture.
All operations were completed successfully by laparoscopy. Three of 248 hysterectomies (1.2%) were complicated by vaginal cuff dehiscence. One of them belonged to the two-layer running suture group, and the others belonged to the interrupted figure-of-eight suture group. However, there was no statistically significant difference in outcomes between the suture methods. One case of trocar site incisional herniation occurred. No ureteral, bladder, or major vascular injury occurred. The overall major complication rate including vaginal bleeding was 2.0% (5/248).
The two-layer running suture technique was safe and effective for vaginal cuff suture during TLH, but there was no statistically significant advantage over the widely used figure-of-eight suture method. Diabetes, cigarette smoking and pelvic adhesions produced statistically significant increased risks of complication.
我们比较了在全腹腔镜子宫切除术(TLH)中不同缝合方式阴道残端裂开和其他手术并发症的发生率,并回顾了并发症患者的特点。
我们纳入了 2007 年 3 月至 2009 年 2 月在韩国大田圣玛丽医院因良性疾病接受 TLH 的 248 例患者。我们评估了 TLH 中不同阴道残端缝合技术的临床结局:广泛使用的间断式 8 字缝合和双层连续缝合。
所有手术均成功通过腹腔镜完成。248 例子宫切除术中有 3 例(1.2%)发生阴道残端裂开。其中 1 例属于双层连续缝合组,其余 2 例属于间断式 8 字缝合组。然而,两种缝合方法的结果没有统计学差异。1 例发生套管部位切口疝。没有发生输尿管、膀胱或大血管损伤。包括阴道出血在内的总体主要并发症发生率为 2.0%(5/248)。
双层连续缝合技术对于 TLH 中的阴道残端缝合是安全有效的,但与广泛使用的 8 字缝合方法相比,没有统计学优势。糖尿病、吸烟和盆腔粘连会产生统计学上显著增加的并发症风险。