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血管闭合装置在围产期子宫切除术中的应用价值:一项回顾性队列研究

Usefulness of vessel-sealing devices for peripartum hysterectomy: a retrospective cohort study.

作者信息

Rossetti Diego, Vitale Salvatore Giovanni, Bogani Giorgio, Rapisarda Agnese Maria Chiara, Gulino Ferdinando Antonio, Frigerio Luigi

机构信息

Department of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy.

出版信息

Updates Surg. 2015 Sep;67(3):301-4. doi: 10.1007/s13304-015-0289-0. Epub 2015 Mar 27.

Abstract

To evaluate the feasibility to perform peripartum hysterectomy (PH) with the introduction of LigaSure™ vessels-sealing device (LVSD) and how it influenced the surgical outcomes. We retrospectively evaluated procedures and outcome of women undergoing PH during the period between January 2001 and October 2013. Perioperative surgical results of patients undergoing PH using LVSD were compared to patients undergoing PH without LVSD. Forty-nine subjects had PH during the study period. Twenty (41%) hysterectomies were performed for placenta accreta, 8 (16%) for placenta previa, 21 (43%) for atony. Twenty-three subjects had PH using LVSD and 26 subjects had hysterectomy without the use of this device. We observe significant differences in estimated blood loss (p = 0.001), massive blood transfusions (>10 units RBC) (p = 0.025), operative time (p = 0.06). No difference in term of hospital stay and complications were observed (p = 0.78 and p = 0.35). One patient for each group had intraoperative complication (p = 0.9). The use of LVSD during PH does not increase operative complications, blood loss, and operative time in comparison to standard procedure.

摘要

评估引入LigaSure™血管闭合装置(LVSD)进行围产期子宫切除术(PH)的可行性及其对手术结果的影响。我们回顾性评估了2001年1月至2013年10月期间接受PH的女性的手术过程和结果。将使用LVSD进行PH的患者的围手术期手术结果与未使用LVSD进行PH的患者进行比较。在研究期间,49名受试者接受了PH。其中,因胎盘植入进行子宫切除术20例(41%),因前置胎盘8例(16%),因宫缩乏力21例(43%)。23名受试者使用LVSD进行PH,26名受试者未使用该装置进行子宫切除术。我们观察到估计失血量(p = 0.001)、大量输血(>10单位红细胞)(p = 0.025)、手术时间(p = 0.06)存在显著差异。在住院时间和并发症方面未观察到差异(p = 0.78和p = 0.35)。每组各有1例患者出现术中并发症(p = 0.9)。与标准手术相比,PH期间使用LVSD不会增加手术并发症、失血量和手术时间。

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