Moawad Gaby N, Abi KhalIL Elias D, Opoku-Anane Jessica, Marfori Cherie Q, Harman Alice C, Fisher Steven, Levy Matt, Robinson James K
Minimally Invasive Gynecologic Surgery, George Washington University, Washington, DC, USA.
Obstetrics & Gynecology Department, George Washington University, Washington, DC, USA.
Acta Obstet Gynecol Scand. 2016 Jan;95(1):52-4. doi: 10.1111/aogs.12783. Epub 2015 Oct 19.
With the growing controversy surrounding power morcellation (PM), other approaches must be examined so that women may still benefit from minimally invasive gynecologic surgeries. In this study we sought to compare power morcellation to manual morcellation through mini-laparotomy or vaginally.
Retrospective cohort study carried out at an urban teaching hospital including 274 women who underwent a minimally invasive myomectomy or hysterectomy, requiring morcellation for tissue extraction. Surgical outcomes were compared between PM, manual morcellation through mini-laparotomy (MMM) and manual morcellation through the vagina (MMV). Primary outcome measured was operative time. Secondary outcomes were intraoperative and postoperative complications.
Compared with PM, MMM was associated with shorter operative time for hysterectomy, (140.5 min vs. 164.2 min, p = 0.05). Intraoperative and postoperative complications were similar among groups. There were four postoperative complications in the MMV group, one related to blood transfusion and three related to postoperative vaginal cuff and pelvic infections.
Compared with PM, MMM is associated with shorter operative time during hysterectomies. Intraoperative and postoperative complications were similar among groups.
随着围绕动力旋切术（PM）的争议不断增加，必须研究其他方法，以便女性仍能从微创妇科手术中获益。在本研究中，我们试图通过迷你剖腹术或经阴道途径将动力旋切术与手动旋切术进行比较。
在一家城市教学医院进行回顾性队列研究，纳入274例行微创子宫肌瘤切除术或子宫切除术且需要旋切术取出组织的女性。比较动力旋切术、经迷你剖腹术手动旋切术（MMM）和经阴道手动旋切术（MMV）的手术结果。测量的主要结局是手术时间。次要结局是术中及术后并发症。
与动力旋切术相比，子宫切除术时MMM的手术时间更短（140.5分钟对164.2分钟，p = 0.05）。各组术中及术后并发症相似。MMV组有4例术后并发症，1例与输血有关，3例与术后阴道断端及盆腔感染有关。
与动力旋切术相比，子宫切除术时MMM的手术时间更短。各组术中及术后并发症相似。
