Department of Obstetrics and Gynaecology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
Arch Gynecol Obstet. 2011 Aug;284(2):379-84. doi: 10.1007/s00404-010-1662-3. Epub 2010 Sep 10.
To evaluate the operative outcomes of patients managed by laparoscopic-assisted vaginal hysterectomy (LAVH) with and without laparoscopic transsection of the uterine artery for benign gynaecologic diseases.
A retrospective analysis of 1,255 women from two different centers undergoing hysterectomy between 1998 and 2009 with benign indications is presented. 856 patients were treated by LAVH type I (vaginal transsection of the uterine artery) and 399 patients by LAVH type II (laparoscopic transsection of the uterine artery). Operative outcomes, intraoperative and postoperative complications, as well as laparoconversion rates were the main objectives of the study.
Median operative time was similar between LAVH type I and II (136 vs. 126 min, respectively, P = NS). Intraoperative complication rate was not significantly different between the two groups of the study (LAVH type I: 1.5% vs. LAVH type II: 1.26%, respectively, P = NS). The injury of the urinary tract, especially of the bladder, was the most common intraoperative complication for both the groups of the study. Laparoconversion rate was similar in LAVH type I and II (0.5 vs. 0.35%, respectively, P = NS), while postoperative complications were significantly higher in LAVH type I (2.25%) compared to LAVH type II (1.16%), mainly because of postoperative vaginal and intrabdominal haemorrhage in the group of the LAVH type I.
LAVH with laparoscopic transsection of the uterine artery is an effective and safe technique with less postoperative complication compared to LAVH with vaginal transsection of the uterine vessels.
评估腹腔镜辅助阴道子宫切除术（LAVH）治疗良性妇科疾病的手术结果，包括是否同时进行腹腔镜子宫动脉横断。
回顾性分析了 1998 年至 2009 年在两个不同中心因良性疾病接受子宫切除术的 1255 名女性患者。856 例患者采用 LAVH Ⅰ型（阴道子宫动脉横断）治疗，399 例患者采用 LAVH Ⅱ型（腹腔镜子宫动脉横断）治疗。本研究的主要目的是评估手术结果、术中及术后并发症以及腹腔镜中转率。
LAVH Ⅰ型和Ⅱ型的中位手术时间相似（分别为 136 分钟和 126 分钟，P = NS）。两组术中并发症发生率无显著差异（LAVH Ⅰ型：1.5%；LAVH Ⅱ型：1.26%，P = NS）。两组最常见的术中并发症均为泌尿系统损伤，尤其是膀胱损伤。LAVH Ⅰ型和Ⅱ型的腹腔镜中转率相似（分别为 0.5%和 0.35%，P = NS），但 LAVH Ⅰ型术后并发症发生率明显高于 LAVH Ⅱ型（2.25%比 1.16%），主要是由于 LAVH Ⅰ型术后阴道和腹腔内出血。
与阴道子宫动脉横断的 LAVH 相比，腹腔镜子宫动脉横断的 LAVH 是一种有效且安全的技术，术后并发症较少。
