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梅拉德切口与切尔尼切口在良性指征子宫切除术手术效果的比较:一项双盲随机对照试验

Comparison of Maylard and Cherney incisions' outcomes in hysterectomy surgery for benign indications: a double-blind randomized controlled trial.

作者信息

Vaezi Maryam, Zarei Roghayeh, Azizi Hosein

机构信息

Department of Obstetrics and Gynecology, Women's Reproductive Health Research Center, School of Medicine, Clinical Research Institute, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Eur J Med Res. 2025 Jan 28;30(1):56. doi: 10.1186/s40001-025-02311-1.

Abstract

OBJECTIVES

Choosing the incision for surgery depends on a variety of factors, including the surgeon's preference, patient preference, surgical indications, the patient's systemic issues, previous surgical scars, and other considerations. This trial aimed to evaluate and compare the surgical outcomes of two techniques-Maylard and Cherney incisions-in benign hysterectomy procedures for women.

MATERIALS AND METHODS

A randomized controlled trial was conducted in Al-Zahra Women's Tertiary Referral University Hospital. A total of 60 patients undergoing benign hysterectomy were randomly allocated to two groups, with one group undergoing surgery with a Maylard incision and the other with a Cherney incision. Surgeries in both groups were performed by a gynecologist oncologist who was a member of the university faculty, accompanied by an Obstetrics and Gynecology Resident.

RESULTS

There were no significant differences in hemoglobin levels or clinical or obstetric characteristics before surgery between the two study groups (p > 0.05). The mean time from skin incision to entering the abdominal cavity was 14.23 min for Maylard and 13.6 min for Cherney (p = 0.091). The average blood loss was 506.6 mL in the Maylard group and 429.3 mL in the Cherney group, which was statistically significant (p = 0.031). Postoperative hemoglobin levels were 11.68 g/dL in the Maylard group and 12.07 g/dL in the Cherney group (p = 0.133). Pain scores were higher in the Cherney group than in the Maylard group (p = 0.041). There were no surgical complications after 1 and 3 months in the study groups.

CONCLUSIONS

No complications were observed in any of the patients following the surgery. The Mylard incision showed a higher level of bleeding in comparison with the Cherney incision, which was linked to more noticeable pain. Nevertheless, both incisions are deemed as effective options for gynecological surgeries, offering superb visibility to the pelvis.

摘要

目的

手术切口的选择取决于多种因素,包括外科医生的偏好、患者的偏好、手术指征、患者的全身状况、既往手术瘢痕以及其他因素。本试验旨在评估和比较两种手术技术(梅拉德切口和切尔尼切口)在女性良性子宫切除术中的手术效果。

材料与方法

在阿尔-扎赫拉妇女三级转诊大学医院进行了一项随机对照试验。共有60例行良性子宫切除术的患者被随机分为两组,一组采用梅拉德切口进行手术,另一组采用切尔尼切口进行手术。两组手术均由大学教员中的妇科肿瘤学家进行,并有妇产科住院医师陪同。

结果

两个研究组术前血红蛋白水平、临床或产科特征均无显著差异(p>0.05)。梅拉德切口从皮肤切开到进入腹腔的平均时间为14.23分钟,切尔尼切口为13.6分钟(p=0.091)。梅拉德组平均失血量为506.6毫升,切尔尼组为429.3毫升,差异有统计学意义(p=0.031)。梅拉德组术后血红蛋白水平为11.68g/dL,切尔尼组为12.07g/dL(p=0.133)。切尔尼组的疼痛评分高于梅拉德组(p=0.041)。研究组在术后1个月和3个月均未出现手术并发症。

结论

术后所有患者均未观察到并发症。与切尔尼切口相比,梅拉德切口的出血量更高,且疼痛更明显。然而,两种切口都被认为是妇科手术的有效选择,能提供极佳的盆腔视野。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03e7/11773955/ecb55d9f54b3/40001_2025_2311_Fig1_HTML.jpg

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