Cavkaytar Sabri, Kokanali Mahmut Kuntay, Topcu Hasan Onur, Aksakal Orhan Seyfi, Doganay Melike
Department of Gynecology, Ankara Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
Department of Gynecology, Ankara Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
J Minim Invasive Gynecol. 2014 Sep-Oct;21(5):884-7. doi: 10.1016/j.jmig.2014.03.025. Epub 2014 Apr 16.
To compare the effects of horizontal and vertical vaginal cuff closure techniques on vagina length after vaginal hysterectomy.
Prospective randomized study (Canadian Task Force classification I).
Teaching and research hospital, a tertiary center.
Fifty-two women with POP-Q stage 0 or 1 uterine prolapse were randomized into 2 groups using vertical (n = 26) or horizontal (n = 26) vaginal cuff closure.
All patients underwent vaginal hysterectomy.
Vagina length in the 2 groups was compared preoperatively, immediately after surgery, and at 6 weeks postoperatively. Mean (SD) preoperative vagina length in the horizontal and vertical groups was similar (7.87 [0.92] cm vs 7.99 [0.78] cm; p = .41). Immediately postoperatively, the vagina was significantly shorter in the horizontal group than in the vertical group (6.61 [0.89] cm vs 7.51 [0.74] cm; p < .001). At 6 weeks postoperatively, the vagina was still significantly shorter in the horizontal group (6.55 [0.89] cm vs 7.42 (0.73) cm; p < .001). The mean difference in vagina length before and after surgery was also significantly higher in the horizontal group than in the vertical group (-1.26 [0.12] cm vs 0.49 [0.11] cm; p < .001).
Vertical cuff closure during vaginal hysterectomy seems to preserve vagina length better than does horizontal cuff closure.
比较阴道子宫切除术后水平和垂直阴道残端闭合技术对阴道长度的影响。
前瞻性随机研究（加拿大工作组分类I）。
教学与研究医院，三级中心。
52例POP-Q分期为0或1期子宫脱垂的女性被随机分为两组，分别采用垂直（n = 26）或水平（n = 26）阴道残端闭合术。
所有患者均接受阴道子宫切除术。
比较两组患者术前手术刚结束时及术后6周时的阴道长度。水平组和垂直组术前阴道平均（标准差）长度相似（7.87 [0.92] cm对7.99 [0.78] cm；p = 0.41）。术后即刻，水平组阴道明显短于垂直组（6.61 [0.89] cm对7.51 [0.74] cm；p < 0.001）。术后6周时，水平组阴道仍明显较短（6.55 [0.89] cm对7.42 [0.73] cm；p < 0.001）。水平组手术前后阴道长度的平均差异也显著高于垂直组（-1.26 [0.12] cm对0.49 [0.11] cm；p < 0.001）。
阴道子宫切除术中垂直残端闭合似乎比水平残端闭合能更好地保留阴道长度。
