Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Gynecol Obstet Invest. 2011;71(3):163-9. doi: 10.1159/000316052. Epub 2010 Dec 14.
To compare the vaginal route and laparoscopic suture for vaginal cuff closure (VCC) in patients undergoing a total laparoscopic hysterectomy (TLH).
A total of 471 women who required hysterectomy were allocated to two groups. 261 women had TLH via VCC by the vaginal route and 210 women had TLH via VCC by laparoscopic suture. All TLHs were performed by the same laparoscopic surgeon.
The cuff-related complications included vaginal disruption (3.4%), dehiscence (1.27%), vaginal vault bleeding (1.91%), vaginal spotting (19.32%), granulation (1.27%), cuff infection (1.49%), and yellowish vaginal discharge (6.16%). No difference in vaginal cuff complications was found between the laparoscopic and vaginal approach. The median operation time was significantly shorter for the laparoscopic suture (76.74 min, range 40-220; 95% CI 74.84-83.45) than the vaginal route for VCC (85.77 min, range 45-290; 95% CI 86.87-95.36) after hysterectomy (p < 0.001).
For VCC with TLH, laparoscopic suture was a safe and less time-consuming procedure. The cuff-related complications were similar in the two groups.
比较经阴道途径和腹腔镜缝合在全腹腔镜子宫切除术（TLH）中阴道残端关闭（VCC）的效果。
将 471 名需要子宫切除术的患者分为两组。261 名患者经阴道行 TLH 经阴道途径 VCC，210 名患者经腹腔镜缝合行 TLH 经阴道途径 VCC。所有 TLH 均由同一位腹腔镜外科医生完成。
残端相关并发症包括阴道撕裂（3.4%）、裂开（1.27%）、阴道穹窿出血（1.91%）、阴道点状出血（19.32%）、肉芽组织形成（1.27%）、残端感染（1.49%）和黄色阴道分泌物（6.16%）。腹腔镜与阴道途径在阴道残端并发症方面无差异。腹腔镜缝合的中位手术时间明显短于经阴道途径 VCC（76.74 分钟，范围 40-220；95%CI 74.84-83.45）（p < 0.001）。
对于 TLH 的 VCC，腹腔镜缝合是一种安全且耗时较短的手术。两组的残端相关并发症相似。
