Mohammed Walid E, Salama Fekrya, Tharwat Ahmed, Mohamed Ibrahim, ElMaraghy Ahmed
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Abbasia, Cairo, Egypt.
Arch Gynecol Obstet. 2017 Jul;296(1):77-83. doi: 10.1007/s00404-017-4397-6. Epub 2017 May 15.
To compare surgical outcomes, postoperative complications and costs between vaginal hysterectomy and laparoscopically assisted vaginal hysterectomy in cases of large uteri.
Prospective randomized controlled trial done at Ain Shams University Maternity Hospital, where 50 patients were recruited and divided into two equal groups (each 25 patients). First group underwent vaginal hysterectomy, and the second underwent laparoscopically assisted vaginal hysterectomy.
Patient characteristics were similar in both groups. As for surgical outcomes, estimated intraoperative blood loss (P = 0.90), operative time (P = 0.48), preoperative hemoglobin (P = 0.09), postoperative hemoglobin (P = 0.42), and operative complications (P = 1.0) did not differ between the two groups. The hospital costs (converted from Egyptian pound to U.S. dollars) were significantly higher in case of LAVH group [VH: $1060.86 ($180.09) versus LAVH: $1560.5 ($220.57), P value <0.001]. No significant difference exists in the duration of postoperative hospital stay between the two groups [VH: 49.92 h (28.50) versus LAVH: 58.56 (27.78), P = 0.28] or the actual uterine weight measured postoperatively [VH: 350.72 g (71.78) versus LAVH: 385.96 g (172.52), P = 0.35].
Both vaginal hysterectomy and laparoscopically assisted vaginal hysterectomy are safe procedures in cases of large uteri with no significant difference between them except in terms of costs as VH appears to be more cost effective. CLINICAL TRIALS.GOV: NCT02826304.
比较阴道子宫切除术与腹腔镜辅助阴道子宫切除术治疗大子宫病例的手术效果、术后并发症及费用。
在艾因夏姆斯大学妇产医院进行前瞻性随机对照试验，招募50例患者并分为两组（每组25例）。第一组接受阴道子宫切除术，第二组接受腹腔镜辅助阴道子宫切除术。
两组患者特征相似。在手术效果方面，两组间估计术中失血量（P = 0.90）、手术时间（P = 0.48）、术前血红蛋白（P = 0.09）、术后血红蛋白（P = 0.42）及手术并发症（P = 1.0）无差异。腹腔镜辅助阴道子宫切除术组的医院费用（从埃及镑换算为美元）显著更高[阴道子宫切除术：1060.86美元（180.09美元），腹腔镜辅助阴道子宫切除术：1560.5美元（220.57美元），P值<0.001]。两组间术后住院时间[阴道子宫切除术：49.92小时（28.50小时），腹腔镜辅助阴道子宫切除术：58.56小时（27.78小时），P = 0.28]或术后实际测量的子宫重量[阴道子宫切除术：350.72克（71.78克），腹腔镜辅助阴道子宫切除术：385.96克（172.52克），P = 0.35]无显著差异。
阴道子宫切除术和腹腔镜辅助阴道子宫切除术治疗大子宫病例均为安全的手术方式，两者除费用外无显著差异，阴道子宫切除术似乎更具成本效益。临床试验注册编号：NCT02826304。
