Ceska Gynekol. 2020 Winter;85(6):385-395.
Comparison of two types of uterine manipulators used in total laparoscopic hysterectomy (TLH) and clinical evaluation of the method in patients in a two-year group supplemented by subjective evaluation.
Prospective observational study.
Department of Gynecology and Obstetrics, Masaryk University, Faculty of Medicine and University Hospital Brno.
A group of patients operated in the years 2018-2019 by the TLH method using one of two types of uterine manipulators - Karl Storz HOHL (group No. 1) vs. plastic ring of Koh's manipulator (group No. 2). We compared surgical time (min), blood loss (ml), perioperative complications, length of hospital stay (days), early and late complications. We were interested in the possible influence of BMI, uterine on these parameters. Subjective evaluation of the method by patients took place before the procedure and 12 weeks after the operation with a standardized questionnaire.
A total of 134 patients were enrolled in the study (75 in group 1 vs. 59 in group 2). The monitored parameters: age, BMI, operative time, blood loss and length of hospitalization did not differ statistically significantly. When comparing the individual groups with different manipulators, the total number of complications (mild difficulties, serious complications) was without statistical significance (p = 0.58), but the spectrum of symptoms was different in both groups. More than a third of the patients in the group were obese. There were more serious complications than non-obese ones, the performance was longer, however, for a small number it was statistically insignificant (p = 0.11). In patients with uterine surgery, we recorded more adhesiolysis. We did not show that previous surgery on the uterus was associated with a higher incidence of complications (p = 0.6). We did not notice any statistically significant difference in the subjective evaluation (p = 0.3).
TLH is the dominant method of uterine removal in our workplace. In a group of 134 women, we did not show a statistically significant difference in the monitored parameters. The HOHL manipulator has proved to be more user-friendly due to its technical parameters and better clarity of the operating field. Subjective evaluation of the method was positive in patients.
比较两种在全腹腔镜子宫切除术（TLH）中使用的子宫操纵器，并对两年组的患者进行补充主观评估的临床评估。
前瞻性观察性研究。
马萨里克大学医学院和布尔诺大学附属医院妇产科。
一组患者在 2018-2019 年接受 TLH 方法手术，使用两种类型的子宫操纵器之一-卡尔·史托斯 HOHL（第 1 组）与科氏操纵器的塑料环（第 2 组）。我们比较了手术时间（分钟）、失血量（毫升）、围手术期并发症、住院时间（天）、早期和晚期并发症。我们对 BMI、子宫对这些参数的可能影响感兴趣。患者在术前和术后 12 周进行了方法的主观评估，使用标准化问卷进行。
共有 134 名患者入组研究（第 1 组 75 例，第 2 组 59 例）。监测的参数：年龄、BMI、手术时间、失血量和住院时间在统计学上无显著差异。当比较具有不同操纵器的各个组时，总并发症数（轻度困难、严重并发症）无统计学意义（p = 0.58），但两组的症状谱不同。超过三分之一的患者肥胖。严重并发症比非肥胖患者多，手术时间较长，但对少数患者无统计学意义（p = 0.11）。在子宫手术患者中，我们记录到更多的粘连松解术。我们没有表明先前的子宫手术与更高的并发症发生率有关（p = 0.6）。我们没有注意到主观评估中有任何统计学上的差异（p = 0.3）。
TLH 是我们工作场所子宫切除的主要方法。在 134 名女性中，我们没有显示监测参数有统计学上的显著差异。HOHL 操纵器由于其技术参数和更好的操作视野清晰度而被证明更易于使用。患者对该方法的主观评估为阳性。
