Department of Obstetrics and Gynaecology, College of Medicine, Dong-A University, Busan, 26 Daesingongwon-Ro Seo-Gu, Busan, 602-812, Republic of Korea.
Department of Obstetrics and Gynaecology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
BMC Womens Health. 2019 Jun 24;19(1):83. doi: 10.1186/s12905-019-0784-4.
There are various surgical approaches of hysterectomy for benign indications. This study aimed to compare vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH) with respect to their complications and operative outcomes.
We selected randomised controlled trials that compared VH with LH for benign gynaecological indications. We included studies published after January 2000 in the following databases: Medline, EMBASE, and CENTRAL (The Cochrane Library). The primary outcome was comparison of the complication rate. The secondary outcomes were comparisons of operating time, blood loss, intraoperative conversion, postoperative pain, length of hospital stay and duration of recuperation. We used Review Manager 5.3 software to perform the meta-analysis.
Eighteen studies of 1618 patients met the inclusion criteria. The meta-analysis showed no differences in overall complications, intraoperative conversion, postoperative pain on the day of surgery and at 48 h, length of hospital stay and recuperation time between VH and LH. VH was associated with a shorter operating time and lower postoperative pain at 24 h than LH.
When both surgical approaches are feasible, VH should remain the surgery of choice for benign hysterectomy.
针对良性指征，子宫切除术有多种手术入路。本研究旨在比较经阴道子宫切除术（VH）和腹腔镜子宫切除术（LH）在并发症和手术结果方面的差异。
我们选择了比较 VH 与 LH 用于良性妇科指征的随机对照试验。我们纳入了自 2000 年 1 月以来在以下数据库中发表的研究：Medline、EMBASE 和 CENTRAL（Cochrane 图书馆）。主要结局是比较并发症发生率。次要结局是比较手术时间、出血量、术中中转、术后疼痛、住院时间和康复时间。我们使用 Review Manager 5.3 软件进行荟萃分析。
符合纳入标准的 1618 例患者的 18 项研究被纳入。荟萃分析显示 VH 与 LH 之间在总体并发症、术中中转、手术当天和 48 小时的术后疼痛、住院时间和康复时间方面无差异。与 LH 相比，VH 具有较短的手术时间和较低的术后 24 小时疼痛。
当两种手术方法均可行时，VH 应仍然是良性子宫切除术的首选术式。
