Department of Obstetrics and Gynecology, China Medical University and Hospital, Taichung, Taiwan.
Taiwan J Obstet Gynecol. 2009 Dec;48(4):400-2. doi: 10.1016/S1028-4559(09)60330-2.
This study aimed to elucidate the possible relationship between surgical blood loss (SBL) and medical outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH).
Patients who underwent LAVH performed by the same surgeon for benign gynecologic diseases from 2004 to 2006 were analyzed retrospectively. Patients were divided into two groups according to the amount of SBL (< 150 mL or > or = 150 mL, 75th percentile of mean SBL). Clinical medical outcomes of all women were analyzed to identify the effects of SBL during LAVH.
A total of 133 women with benign gynecologic disease were included. Group 1 (SBL < 150 mL) consisted of 108 patients and Group 2 (SBL > or = 150 mL) consisted of 25 patients. The mean operative time for patients with SBL > or = 150 mL was 36.1 minutes longer than that for patients with SBL < 150 mL (p < 0.001). Mean hospital stay, mean shift in serum hemoglobin, mean shift in serum hematocrit and mean flatulence relief time were not significantly different between the two groups.
Greater SBL (> or = 150 mL) during LAVH was significantly associated with longer operating time, but had no detrimental effect on short-term surgical outcomes. Thus, efforts to minimize intraoperative bleeding and so reduce operative time will be beneficial for women undergoing LAVH.
本研究旨在阐明腹腔镜辅助阴式子宫切除术(LAVH)中手术失血量(SBL)与医疗结果之间可能存在的关系。
回顾性分析 2004 年至 2006 年间由同一位外科医生为良性妇科疾病行 LAVH 的患者。根据 SBL 量将患者分为两组(<150 mL 或 >或= 150 mL,SBL 均值的第 75 个百分位数)。分析所有女性的临床医疗结果,以确定 LAVH 期间 SBL 的影响。
共有 133 名患有良性妇科疾病的女性纳入本研究。SBL <150 mL 的患者为 108 例(组 1),SBL ≥150 mL 的患者为 25 例(组 2)。SBL ≥150 mL 的患者的手术时间比 SBL <150 mL 的患者长 36.1 分钟(p<0.001)。两组间的平均住院时间、平均血清血红蛋白变化、平均血清血细胞比容变化和平均排气缓解时间无显著差异。
LAVH 中较大的 SBL(≥150 mL)与手术时间延长显著相关,但对短期手术结果无不良影响。因此,努力减少术中出血和缩短手术时间将有利于行 LAVH 的女性。