Lee Soo-Jeong, Roh Hyun-Jin, Cho Hyun-Jin, Lee Sang-Hun, Ahn Jun-Woo, Kwon Yong-Soon
Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
Department of Obstetrics and Gynaecology, University of Inje College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea.
Gynecol Minim Invasive Ther. 2017 Apr-Jun;6(2):58-62. doi: 10.1016/j.gmit.2016.04.005. Epub 2016 Jun 11.
To evaluate the feasibility and safety of vaginal vault drainage after complicated singleport access laparoscopic-assisted vaginal hysterectomy (SPA-LAVH).
Retrospective cohort study.
Ulsan University Hospital (tertiary teaching hospital), South Korea.
A total of 359 women underwent SPA-LAVH for the following conditions: benign uterine tumor, preinvasive uterine lesion, and microinvasive cervical cancer.
The participants included 124 women with vault drains and 235 women without drains.
Surgical outcomes, perioperative complications and morbidity, postoperative febrile morbidity.
There were no differences in background features between drain and no-drain groups. In surgical outcomes, mean uterine weight (364.2 ± 184.9 g vs. 263.7 ± 138.6 g; < 0.001), operation time (87.4 ± 21.5 min vs. 73.0 ± 17.6 min; < 0.001), blood loss (225.3 ± 122.2 mL vs. 150.4 ± 95.2 mL; < 0.001), and hemoglobin decline (1.97 ± 0.96 g/dL vs. 1.42 ± 0.89 g/dL; < 0.001) were significantly larger for the drain group compared with the no-drain group. However, with regard to postoperative morbidity and complications, there were no group differences in the transfusion rates (6.5% vs. 3.8%; = 0.300), intraoperative complications (2.4% vs. 1.3%; = 0.420), perioperative complications (2.4% vs. 0.9%; = 0.345), and febrile morbidity ≥ 37.5°C (8.9% vs. 11.5%; = 0.477), although the drain group was more prone to the development of pelvic fluid collection and febrile morbidity than the no-drain group.
Vaginal vault drainage could be a safe alternative that allows for the management of postoperative morbidity and retains the advantages of minimally invasive surgery after complicated SPA-LAVH.
评估复杂单孔腹腔镜辅助阴式子宫切除术（SPA-LAVH）后阴道残端引流的可行性和安全性。
回顾性队列研究。
韩国蔚山大学医院（三级教学医院）。
共有359名女性因以下情况接受了SPA-LAVH手术：良性子宫肿瘤、子宫浸润前病变和微浸润性宫颈癌。
参与者包括124名有残端引流的女性和235名无引流的女性。
手术结果、围手术期并发症和发病率、术后发热发病率。
引流组和无引流组的背景特征无差异。在手术结果方面，引流组的平均子宫重量（364.2±184.9克对263.7±138.6克；<0.001）、手术时间（87.4±21.5分钟对73.0±17.6分钟；<0.001）、失血量（225.3±122.2毫升对150.4±95.2毫升；<0.001）和血红蛋白下降（1.97±0.96克/分升对1.42±0.89克/分升；<0.001）均显著高于无引流组。然而，在术后发病率和并发症方面，输血率（6.5%对3.8%；=0.300）、术中并发症（2.4%对1.
