全腹腔镜子宫切除术：我们的5年经验（1998 - 2002年）
Total laparoscopic hysterectomy: our 5-year experience (1998-2002).
作者信息
Bonilla David J, Mains Lindsay, Rice Janet, Crawford Benjamin
出版信息
Ochsner J. 2010 Spring;10(1):8-12.
PURPOSE
To review our experience performing total laparoscopic hysterectomy since we first introduced this procedure in 1998.
METHODS
A retrospective cohort study was performed for patients undergoing total laparoscopic hysterectomy at Ochsner Clinic Foundation from February 1998 through December 2002. Rates of complications, successful completion, length of hospital stay, readmission, and reoperation were determined for this period.
RESULTS
Among 511 patients who underwent attempted total laparoscopic hysterectomy, 487 procedures (95.3%) were completed by laparoscopy. The major intraoperative complication rate was 3.9%, and the major postoperative complication rate was 4.7%. No significant differences were seen in the intraoperative and postoperative complication rates of patients who were morbidly obese (body mass index ≥30 kg/m(2)), patients with enlarged uteri (≥300 g), or patients who underwent concomitant procedures (unilateral or bilateral salpingo-oophorectomy and lysis of adhesions). The readmission rate was 4.1%, and the reoperation rate was 2%. None of the variables studied, including age, medical problems, morbid obesity, concomitant procedures, or enlarged uterus, were found to have an association with readmission or reoperation rates.
CONCLUSIONS
Total laparoscopic hysterectomy can be performed successfully in most patients with benign indications. Morbidity is comparable to that of other types of hysterectomies, and this technique may be a more reasonable approach under some circumstances.
目的
回顾自1998年首次引入全腹腔镜子宫切除术以来我们的手术经验。
方法
对1998年2月至2002年12月在奥施纳临床基金会接受全腹腔镜子宫切除术的患者进行回顾性队列研究。确定该时期的并发症发生率、手术成功完成率、住院时间、再入院率和再次手术率。
结果
在511例尝试进行全腹腔镜子宫切除术的患者中，487例（95.3%）通过腹腔镜完成手术。术中主要并发症发生率为3.9%，术后主要并发症发生率为4.7%。病态肥胖（体重指数≥30 kg/m²）、子宫增大（≥300 g）或同时进行其他手术（单侧或双侧输卵管卵巢切除术及粘连松解术）的患者，其术中及术后并发症发生率未见显著差异。再入院率为4.1%，再次手术率为2%。未发现所研究的任何变量，包括年龄、医疗问题、病态肥胖、同时进行的手术或子宫增大，与再入院率或再次手术率有关。
结论
大多数有良性指征的患者可成功进行全腹腔镜子宫切除术。其发病率与其他类型子宫切除术相当，在某些情况下，该技术可能是一种更合理的方法。
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