Gadonneix P, Dauplat J, Rodier J F, Issert B, Giraud B
Service de Chirurgie, Centre Jean Perrin, Clermont-Ferrand.
Rev Fr Gynecol Obstet. 1987 Oct;82(10):555-60.
The authors present a retrospective study of 1,000 total abdominal hysterectomies performed between 1969 and 1975, and they report the main complications. Early complications are dominated by: rare thrombo-embolic accidents (2.2%) since the advent of prophylactic heparin therapy; infectious complications, dominated by the abscess of the abdominal wall and asymptomatic urinary infections, and for which simple measures prevent resorting to prophylactic antibiotherapy. The role of the hysterectomy seems minimal in the occurrence of a prolapse or a stress-related urinary incontinence: prolapses after hysterectomy (1.4%) seem more related to tissue aging than to the procedure which modifies very little the supporting system of the pelvis. A post-operative urinary incontinence is, most of the time, the result of an incomplete pre-operative work-up: failure to recognize a potential stress-related incontinence, or an incontinence secondary to an unstable bladder. Prolapse and incontinence must always be treated independently. In the psychological and sexual repercussion, age, ovariectomy and the distress related to the procedure, involving the heart of womanhood, seem to be the most important factors.
作者对1969年至1975年间进行的1000例全腹子宫切除术进行了回顾性研究，并报告了主要并发症。早期并发症主要包括：自预防性肝素治疗出现以来罕见的血栓栓塞事故（2.2%）；感染性并发症，以腹壁脓肿和无症状尿路感染为主，对于这些并发症，采取简单措施即可避免预防性使用抗生素治疗。子宫切除术在子宫脱垂或压力性尿失禁的发生中作用似乎极小：子宫切除术后的脱垂（1.4%）似乎更多与组织老化有关，而非与对骨盆支撑系统改变极小的手术操作有关。术后尿失禁多数情况下是术前检查不全面的结果：未能识别潜在的压力性尿失禁，或继发于膀胱不稳定的尿失禁。子宫脱垂和尿失禁必须始终独立治疗。在心理和性方面的影响中，年龄、卵巢切除术以及与涉及女性核心问题的手术相关的困扰似乎是最重要的因素。
