Department of Obstetrics and Gynecology, Thai-German Multidisciplinary Endoscopic Training Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Int J Gynaecol Obstet. 2012 Feb;116(2):109-11. doi: 10.1016/j.ijgo.2011.09.022. Epub 2011 Nov 17.
To compare the surgical outcomes of laparoscopic hysterectomy (LH) versus abdominal hysterectomy (AH) in patients with severe pelvic endometriosis.
A retrospective review of patients undergoing hysterectomy for endometriosis was conducted between January 2002 and December 2007. A total of 503 patients had severe pelvic endometriosis; of these, 115 patients underwent LH and 388 patients underwent AH. Surgical outcomes-including operative time, blood loss, length of hospital stay, and need for blood transfusion-were analyzed and compared between the 2 treatment groups.
Operative time was significantly longer for LH than for AH (185.1 ± 48.7 minutes and 139.9 ± 52.4 minutes, respectively; P<0.001). However, estimated volume of blood loss, length of hospital stay, and complication rates were significantly less for patients in the LH group than for those in the AH group (302.6 ± 255.1 mL versus 760.9 ± 633.2 mL [P<0.001]; 3.5 ± 1.1 days versus 6.4 ± 3.0 days [P<0.001]; and 18.3% versus 49.0% [P<0.001], respectively).
Compared with AH, LH was associated with fewer complications. LH should, therefore, be the preferred surgical option for women with severe pelvic endometriosis who require a hysterectomy.
比较腹腔镜子宫切除术（LH）与剖腹子宫切除术（AH）治疗严重盆腔子宫内膜异位症患者的手术结局。
回顾性分析 2002 年 1 月至 2007 年 12 月期间因子宫内膜异位症接受子宫切除术的患者。共有 503 例患者患有严重盆腔子宫内膜异位症；其中 115 例行 LH，388 例行 AH。分析并比较了 2 组治疗患者的手术结局，包括手术时间、出血量、住院时间和输血需求。
LH 的手术时间明显长于 AH（185.1 ± 48.7 分钟和 139.9 ± 52.4 分钟，P<0.001）。然而，LH 组患者的估计出血量、住院时间和并发症发生率明显低于 AH 组（302.6 ± 255.1 mL 比 760.9 ± 633.2 mL，P<0.001；3.5 ± 1.1 天比 6.4 ± 3.0 天，P<0.001；18.3%比 49.0%，P<0.001）。
与 AH 相比，LH 并发症更少。因此，对于需要子宫切除术的严重盆腔子宫内膜异位症患者，LH 应作为首选手术方法。
