He Hongying, Yang Zhijun, Zeng Dingyuan, Fan Jiangtao, Hu Xiaoxia, Ye Yuan, Bai Hua, Jiang Yanming, Lin Zhong, Lei Zhiying, Li Xinlin, Li Lian, Gan Jinghua, Lan Ying, Tang Xiongzhi, Wang Danxia, Jiang Junsong, Wu Xiaoyan, Li Meiying, Ren Xiaoqing, Yang Xiaomin, Liu Mei, Wang Qinmei, Jiang Fuyan, Li Li
Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China;
Department of Gynecological Oncology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China;
Chin J Cancer Res. 2016 Apr;28(2):187-96. doi: 10.21147/j.issn.1000-9604.2016.02.06.
To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy (LH) compared with abdominal hysterectomy (AH) in case of benign gynecological disease.
A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies (3,539 LH vs.1,356 AH) between 2007 and 2013 was involved. Operative time (OT), estimated blood loss (EBL), intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed.
The EBL (174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively), passing flatus (38.7±14.1 vs. 48.1±13.2 hours), days with indwelling catheter (1.5±0.6 vs. 2.2±0.8 days), use of analgesics (6.5% vs. 73.1%), intra-operative complication rate (2.4% vs. 4.1%), post-operative complication rate (2.3% vs. 5.7%), post-operative constipation (12.1% vs. 24.6%), mild and serious stress urinary incontinence (SUI) post-operative (P<0.001; P=0.014), and proportion of Female Sexual Functioning Index (FSFI) total score <26.55 post-operative (P<0.001) of the LH group were significantly less than those of AH group. There were no significant differences in OT (106.5±34.5 vs. 106.2±40.3 min) between the two groups.
LH is a safe and efficient operation for improving patients?long-term quality of life (QoL), and LH is a cost-effectiveness procedure for treating benign gynecological disease. LH is superior to AH due to reduced EBL, reduced post-operative pain and earlier passing flatus.
评估良性妇科疾病患者行腹腔镜子宫切除术（LH）与经腹子宫切除术（AH）后的短期和长期结局。
纳入一项多中心队列回顾性比较研究，研究对象为2007年至2013年间4895例行子宫切除术的患者（3539例行LH，1356例行AH）。评估手术时间（OT）、估计失血量（EBL）、术中及术后并发症、排气时间、留置导尿管天数，以及涵盖盆底功能和性功能的问卷。
LH组和AH组的EBL分别为（174.1±157.4 vs. 263.1±183.2 cc）、排气时间（38.7±14.1 vs. 48.1±13.2小时）、留置导尿管天数（1.5±0.6 vs. 2.2±0.8天）、镇痛药使用情况（6.5% vs. 73.1%）、术中并发症发生率（2.4% vs. 4.1%）、术后并发症发生率（2.3% vs. 5.7%）、术后便秘发生率（12.1% vs. 24.6%）、术后轻度和重度压力性尿失禁（SUI）发生率（P<0.001；P=0.014），以及术后女性性功能指数（FSFI）总分<26.55的比例（P<0.001），LH组均显著低于AH组。两组间OT无显著差异（106.5±34.5 vs. 106.2±40.3分钟）。
LH是一种安全有效的手术方式，可改善患者的长期生活质量（QoL），且LH是治疗良性妇科疾病的一种性价比高的手术。由于EBL减少、术后疼痛减轻和排气更早，LH优于AH。
