Sharp HT, Dorsey JH, Holtz PM, Melick CF
Department of Ob/Gyn, University Medical Center, 50 North Medical Drive, 2B200, Salt Lake City, UT 84132.
J Am Assoc Gynecol Laparosc. 1996 Aug;3(4, Supplement):S45-6. doi: 10.1016/s1074-3804(96)80291-x.
We compared the operating room time using bipolar electrocoagulation and Endo GIA staples in 11 women undergoing laparoscopic-assisted vaginal hysterectomy (LAVH). Electrocoagulation was used on one side of the uterine pedicles and the Endo GIA stapling device on the contralateral pedicles. Each patient was randomized to the method used on each side and which method was used first. All procedures were symmetric, with or without bilateral salpingo-oophorectomy. Data were compared using the paired t test. Normal distribution was assessed by the Shapiro-Wilks test and the K-S (Lilliefors) test. The mean (± SD) procedure times for electrocoagulation and Endo GIA were 13.03 ± 1.34 minutes and 4.4 ± 0.33 minutes, respectively. This resulted in a mean difference of 8.66 ± 3.62 minutes (p <0.001). Patients requiring longer electrocoagulation times also required longer Endo GIA stapling times (p = 0.034). The Endo GIA stapling device required significantly less time to perform LAVH compared with electrocoagulation. The difference of 8.66 minutes, if multiplied by 2 (to account for a bilateral procedure), may or may not be clinically or economically significant, depending on hospital costs and charges for instruments, operating room time, and anesthesia.
我们比较了11例行腹腔镜辅助阴式子宫切除术（LAVH）的女性患者使用双极电凝和Endo GIA吻合器的手术时间。子宫蒂一侧使用电凝，对侧子宫蒂使用Endo GIA吻合器。每位患者均随机分配两侧所使用的方法以及首先使用的方法。所有手术均为对称操作，无论是否行双侧输卵管卵巢切除术。采用配对t检验比较数据。通过Shapiro-Wilks检验和K-S（Lilliefors）检验评估正态分布。电凝和Endo GIA的平均（±标准差）手术时间分别为13.03±1.34分钟和4.4±0.33分钟。这导致平均差值为8.66±3.62分钟（p<0.001）。电凝时间较长的患者Endo GIA吻合时间也较长（p = 0.034）。与电凝相比，Endo GIA吻合器进行LAVH所需时间明显更少。8.66分钟的差值，如果乘以2（以考虑双侧手术），根据医院器械成本、收费、手术时间和麻醉费用，在临床上或经济上可能有意义，也可能没有意义。
