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腹腔镜次全子宫切除术(LSH)与全腹腔镜子宫切除术(TLH)后患者报告的生活质量和性功能结果:一项对915例患者进行的基于问卷的前瞻性随访研究。

Patient-reported quality-of-life and sexual-function outcomes after laparoscopic supracervical hysterectomy (LSH) versus total laparoscopic hysterectomy (TLH): a prospective, questionnaire-based follow-up study in 915 patients.

作者信息

Brucker Sara Y, Taran Florin-Andrei, Bogdanyova Sandra, Ebersoll Sandra, Wallwiener Christian W, Schönfisch Birgitt, Krämer Bernhard, Abele Harald, Neis Felix, Sohn Christof, Gawlik Stephanie, Wallwiener Diethelm, Wallwiener Markus

机构信息

Department of Obstetrics and Gynecology, Tübingen University Hospital, Tübingen, Germany.

出版信息

Arch Gynecol Obstet. 2014 Dec;290(6):1141-9. doi: 10.1007/s00404-014-3318-1. Epub 2014 Jun 29.

Abstract

PURPOSE

To compare patient-reported quality-of-life and sexual function outcomes in women after laparoscopic supracervical hysterectomy (LSH) or total laparoscopic hysterectomy (TLH) for benign uterine disease.

METHODS

Out of a cohort of 1,952 patients from a previous implementation study of LSH and TLH, 1,886 patients who had not undergone intraoperative conversion to laparotomy or were ineligible for other reasons were invited by mail to participate in this prospective, questionnaire-based follow-up study.

RESULTS

Of the 915/1,952 (48.5 %) survey respondents included in the analysis, 788 (86.1 %) and 127 (13.9 %) had undergone LSH or TLH, respectively. Women undergoing LSH reported significantly lower pain levels (p = 0.037) and faster partial (p = 0.015) and complete (p < 0.001) resumption of normal daily activities compared to those undergoing TLH. As regards sexual function, women undergoing LSH resumed sexual activity significantly sooner (p = 0.018), rated sexual desire as higher (p = 0.023), and reported more frequently that their sexual life had improved postoperatively (p = 0.008) than did women undergoing TLH.

CONCLUSIONS

Women undergoing LSH for benign uterine disease may have better outcomes regarding certain quality-of-life and sexual function parameters than women undergoing TLH for benign uterine disease.

摘要

目的

比较因良性子宫疾病接受腹腔镜次全子宫切除术(LSH)或全腹腔镜子宫切除术(TLH)的女性患者报告的生活质量和性功能结果。

方法

在之前一项关于LSH和TLH实施研究的1952名患者队列中,通过邮件邀请1886名未在术中转为开腹手术或因其他原因不符合条件的患者参与这项基于问卷的前瞻性随访研究。

结果

纳入分析的915/1952名(48.5%)调查对象中,分别有788名(86.1%)和127名(13.9%)接受了LSH或TLH。与接受TLH的女性相比,接受LSH的女性报告疼痛程度显著更低(p = 0.037),恢复正常日常活动的部分(p = 0.015)和完全(p < 0.001)恢复速度更快。在性功能方面,接受LSH的女性恢复性活动的时间显著更早(p = 0.018),对性欲的评分更高(p = 0.023),且更频繁地报告其性生活在术后有所改善(p = 0.008)。

结论

因良性子宫疾病接受LSH的女性在某些生活质量和性功能参数方面可能比因良性子宫疾病接受TLH的女性有更好的结果。

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