Müller Andreas, Thiel Falk C, Renner Stefan P, Winkler Mathias, Häberle Lothar, Beckmann Matthias W
Frauenklinik, Universitätsklinikum Erlangen.
Dtsch Arztebl Int. 2010 May;107(20):353-9. doi: 10.3238/arztebl.2010.0353. Epub 2010 May 21.
The advantages and disadvantages of the various surgical techniques for hysterectomy are currently a topic of debate, with particular controversy over leaving the cervix in situ in the laparoscopic supracervical hysterectomy (LASH) procedure.
In a retrospective single-center study, medical history and clinical characteristics were compared in patients who had undergone hysterectomy for benign disease in the period 2002-2008 at the Department of Obstetrics and Gynecology, Erlangen University Hospital. Postoperative satisfaction and the frequency of secondary operations for prolapse or incontinence in women with surgery between 2002 and 2007 were surveyed by means of a questionnaire.
The longest hospital stay was observed after abdominal hysterectomy (AH; 10 days), followed by vaginal hysterectomy (VH; 7.8 days) and laparoscopy-assisted vaginal hysterectomy (LAVH; 7.2 days). The shortest stays in hospital were seen after LASH (5.9 days) and total laparoscopic hysterectomy (TLH; 5.7 days). The shortest operating time was noted with VH (87 min) and the longest with LAVH (122 min). The lowest rates of blood loss were with LASH (1.38 g/dL) and TLH (1.51 g/dL). The highest rate of postoperative complications occurred after AH (8.9%). No differences were found in relation to postoperative satisfaction or surgery for prolapse or incontinence.
No postoperative benefits were found for leaving the cervix in situ when performing LASH. However, this was not a controlled randomized study.
目前，各种子宫切除术手术技术的优缺点是一个争论的话题，尤其是在腹腔镜次全子宫切除术（LASH）中保留宫颈原位的问题上存在特别的争议。
在一项回顾性单中心研究中，对2002年至2008年期间在埃尔朗根大学医院妇产科因良性疾病接受子宫切除术的患者的病史和临床特征进行了比较。通过问卷调查了2002年至2007年期间接受手术的女性的术后满意度以及因脱垂或尿失禁进行二次手术的频率。
腹式子宫切除术（AH）后观察到最长住院时间（10天），其次是阴式子宫切除术（VH；7.8天）和腹腔镜辅助阴式子宫切除术（LAVH；7.2天）。LASH（5.9天）和全腹腔镜子宫切除术（TLH；5.7天）后的住院时间最短。VH的手术时间最短（87分钟），LAVH的手术时间最长（122分钟）。LASH（1.38 g/dL）和TLH（1.51 g/dL）的失血量最低。AH后的术后并发症发生率最高（8.9%）。在术后满意度或脱垂或尿失禁手术方面未发现差异。
进行LASH时保留宫颈原位未发现术后益处。然而，这不是一项对照随机研究。
