Malkan Nur Derya, Aktürk Hilal, Tekin Cansu, Şahin Sadık
Obstetrics and Gynecology, Adiyaman Kahta State Hospital, Istanbul, TUR.
Obstetrics and Gynecology, Muş Malazgirt State Hospital, Istanbul, TUR.
Cureus. 2025 Mar 22;17(3):e80978. doi: 10.7759/cureus.80978. eCollection 2025 Mar.
Hysterectomy is a common gynecological procedure, with laparoscopic techniques increasingly favored for their minimally invasive nature. The use of drains during total laparoscopic hysterectomy (TLH) remains controversial, with conflicting evidence regarding their efficacy and impact on outcomes.
This retrospective study analyzed data from 415 patients who underwent TLH for benign indications at Istanbul Zeynep Kamil Women's and Children's Diseases Training and Research Hospital between 2020 and 2022. Patients were categorized into two groups based on drain application. Demographic and clinical data were collected, and perioperative and postoperative outcomes were compared between groups.
Of the 415 patients, 277 (66.7%) received drains during TLH. Analysis revealed that patients who received drains had significantly longer operation times, an increased length of hospital stay, higher complication rates, and a greater need for transfusion than those without drains. Although preoperative hemoglobin levels were similar between groups, postoperative levels were significantly lower in drain recipients. However, there was no significant difference in postoperative gas discharge rates between groups.
This study suggests drain application during TLH may predict bleeding complications and influence perioperative outcomes. Despite limitations, including their retrospective nature, the findings contribute to the ongoing debate surrounding drain use in TLH and provide valuable insights for clinical practice. Further prospective studies are warranted to validate these findings and guide evidence-based decision-making in gynecological surgery.
子宫切除术是一种常见的妇科手术，腹腔镜技术因其微创性越来越受到青睐。全腹腔镜子宫切除术（TLH）中引流管的使用仍存在争议，关于其疗效及对手术结果的影响证据相互矛盾。
这项回顾性研究分析了2020年至2022年期间在伊斯坦布尔泽伊内普·卡米尔妇女儿童医院因良性指征接受TLH手术的415例患者的数据。根据是否使用引流管将患者分为两组。收集人口统计学和临床数据，并比较两组的围手术期和术后结果。
415例患者中，277例（66.7%）在TLH手术期间使用了引流管。分析显示，使用引流管的患者手术时间明显更长，住院时间延长，并发症发生率更高，输血需求也比未使用引流管的患者更大。尽管两组术前血红蛋白水平相似，但使用引流管的患者术后血红蛋白水平明显更低。然而，两组术后气体排出率没有显著差异。
本研究表明，TLH手术期间使用引流管可能预示出血并发症并影响围手术期结果。尽管存在包括回顾性研究性质等局限性，但研究结果为围绕TLH手术中引流管使用的持续争论做出了贡献，并为临床实践提供了有价值的见解。有必要进行进一步的前瞻性研究来验证这些发现，并指导妇科手术中的循证决策。
