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子宫切除术:良性疾病手术方法对恢复和生活质量的影响。

The hysterectomy: influence of the surgical method in benign disease on convalescence and quality of life.

机构信息

Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Department of Medical Statistics and Biomathematics, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany.

出版信息

Arch Gynecol Obstet. 2023 Mar;307(3):797-806. doi: 10.1007/s00404-022-06778-9. Epub 2022 Oct 27.

Abstract

PURPOSE

The aim of this study was to evaluate the postoperative course after different methods of hysterectomy for benign diseases with special emphasis on time to recovery and patient-centred aspects such as postoperative quality of life and satisfaction.

METHODS

A collective of 242 women who had undergone vaginal hysterectomy (VH), laparoscopic supracervical hysterectomy (LASH) or total laparoscopic hysterectomy (TLH) for various benign conditions was studied in this retrospective investigation. Patients completed a standardised questionnaire addressing quality of life, recovery and sick leave as well as general questions on their postoperative course after hysterectomy.

RESULTS

A total of 242 cases were analysed (82 VH, 92 LASH and 68 TLH). The data demonstrate significant differences in regard to age between groups. The present study shows shorter hospitalisation with laparoscopy, with LASH patients returning to work at least one week earlier on average. There were no relevant differences in the overall postoperative course during the index hospital stay. In the long run, laparoscopic patients were not more satisfied with their choice than VH patients.

CONCLUSION

No significant long-term differences could be observed in terms of quality of life and overall postoperative satisfaction between VH and LH groups. In regard to socioeconomic aspects, laparoscopic approaches were associated with shorter hospitalisation and LASH patients returning to work at least one week earlier on average. Contrary to these data on objective recovery; however, a laparoscopic approach did not lead to patient-perceived, i.e. subjective improvement of time to full recovery.

摘要

目的

本研究旨在评估不同方法治疗良性疾病的术后过程,特别强调恢复时间和以患者为中心的方面,如术后生活质量和满意度。

方法

本回顾性研究共纳入 242 名因各种良性疾病接受阴道子宫切除术(VH)、腹腔镜子宫次全切除术(LASH)或全腹腔镜子宫切除术(TLH)的女性患者。患者完成了一份标准化问卷,内容涉及生活质量、恢复和病假情况,以及术后恢复方面的一般问题。

结果

共分析了 242 例病例(82 例 VH、92 例 LASH 和 68 例 TLH)。各组间的年龄数据存在显著差异。本研究表明腹腔镜手术的住院时间更短,LASH 患者平均提前一周左右恢复工作。在指数住院期间,整体术后过程无明显差异。从长远来看,腹腔镜组患者对其选择的满意度并不比 VH 组患者高。

结论

VH 和 LH 组在生活质量和整体术后满意度方面没有明显的长期差异。就社会经济方面而言,腹腔镜方法与较短的住院时间相关,LASH 患者平均提前一周左右恢复工作。然而,与这些客观恢复数据相反,腹腔镜方法并没有导致患者感知的,即完全恢复时间的主观改善。

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Surgical approach to hysterectomy for benign gynaecological disease.良性妇科疾病的子宫切除术手术入路。
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本文引用的文献

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Total laparoscopic hysterectomy for large uterus.大子宫的全腹腔镜子宫切除术
J Gynecol Endosc Surg. 2009 Jan;1(1):34-9. doi: 10.4103/0974-1216.51908.

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