Bojahr B, Römer T, Lober R, Straube W
Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Fakultät, Ernst-Moritz-Arndt-Universität, Greifswald.
Zentralbl Gynakol. 1995;117(11):585-91.
First experiences after the introduction of LAVH with regard to intra- and postoperative parameters of quality in comparison with the classical abdominal and vaginal hysterectomies are shown. The main indications for LAVH were large myomas, previous pelvic surgery and adnexal mass. Intra- and postoperative complications, time of operation, uterine weight, estimated blood loss, the period of use of analgetics and discharge wishes of 40 patients after abdominal and 25 after vaginal hysterectomies were compared with the results of 30 patients after LAVH. Patients after abdominal hysterectomy need more and longer analgetics. The lowest perioperative morbidity we found in the LAVH group. In cases with enlarged uteri the high blood loss during the vaginal hysterectomy can be significantly reduced with LAVH. LAVH offers a new technique to convert a lot of abdominal hysterectomies with benign indications (large myomas, adhesions, adnexal mass) into vaginal hysterectomies.
展示了与传统腹部和阴道子宫切除术相比,采用腹腔镜辅助阴式子宫切除术(LAVH)后的首次经验,涉及术中及术后质量参数。LAVH的主要适应证为大肌瘤、既往盆腔手术史和附件包块。将40例行腹部子宫切除术和25例行阴道子宫切除术患者的术中及术后并发症、手术时间、子宫重量、估计失血量、镇痛药使用时间及出院意愿,与30例行LAVH患者的结果进行了比较。腹部子宫切除术后的患者需要更多且更长时间使用镇痛药。我们发现LAVH组围手术期发病率最低。对于子宫增大的病例,LAVH可显著减少阴道子宫切除术中的高失血量。LAVH提供了一种新技术,可将许多具有良性适应证(大肌瘤、粘连、附件包块)的腹部子宫切除术转变为阴道子宫切除术。