Nagata Hiroki, Komatsu Hiroaki, Nagaya Yohei, Tsukihara Satoru, Sarugami Masako, Harada Tasuku, Kanamori Yasunobu
Division of Reproductive-Perinatal Medicine and Gynecologic Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
Department of Obstetrics and Gynecology, Japanese Red Cross Yamaguchi Hospital, Yamaguchi 753-0092, Japan.
Yonago Acta Med. 2019 Oct 25;62(4):273-277. doi: 10.33160/yam.2019.11.002. eCollection 2019 Dec.
The present study aimed to determine whether total laparoscopic hysterectomy (TLH) is being implemented safely and appropriately compared with abdominal total hysterectomy (ATH) in our hospital.
We retrospectively reviewed clinical records of 102 patients who underwent total hysterectomy for benign gynecological disease at Japanese Red Cross Yamaguchi Hospital from January 2017 to August 2018. We examined periods of hospital stay, operation time, blood loss, weight of the uterus, frequency of perioperative complications, and the duration from the first visit to the date of surgery. < 0.05 was considered to be statistically significant indicated statistical significance.
TLH and ATH were performed in 55 (53%) and 47 (46%) cases, respectively. The TLH group had significantly longer total operation time [133 (82-205) min vs. 87 (57-155) min, < 0.0001], lesser blood loss [5 (5-35) g vs. 100 (10-820) g, < 0.0001], shorter hospital stay [7 (5-14) days vs. 10 (9-26) days, < 0.0001], and lighter uterine weight [206 (27-658) g vs. 554 (79-2284) g, < 0.0001] than the ATH group. The frequency of perioperative complications did not differ between the two groups (3.5% vs. 8.0%, = 0.4103).
TLH had a longer operation time and a lesser excised uterine weight, but it had less intraoperative blood loss, shorter hospital stay, and no difference in perioperative complication frequency when compared with ATH.
本研究旨在确定在我院与腹式全子宫切除术（ATH）相比，全腹腔镜子宫切除术（TLH）的实施是否安全且恰当。
我们回顾性分析了2017年1月至2018年8月在日本红十字山口医院因良性妇科疾病接受全子宫切除术的102例患者的临床记录。我们检查了住院时间、手术时间、失血量、子宫重量、围手术期并发症发生率以及从首次就诊到手术日期的时长。P<0.05被认为具有统计学意义。
分别有55例（53%）和47例（46%）患者接受了TLH和ATH。TLH组的总手术时间显著更长[133（82 - 205）分钟 vs. 87（57 - 155）分钟，P<0.0001]，失血量更少[5（5 - 35）克 vs. 100（10 - 820）克，P<0.0001]，住院时间更短[7（5 - 14）天 vs. 10（9 - 26）天，P<0.0001]，子宫重量更轻[206（27 - 658）克 vs. 554（79 - 2284）克，P<0.0001]。两组围手术期并发症发生率无差异（3.5% vs. 8.0%，P = 0.4103）。
与ATH相比，TLH的手术时间更长，切除的子宫重量更轻，但术中失血量更少，住院时间更短，围手术期并发症发生率无差异。
