Lee C L, Lai Y M, Soong Y K
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung Medical School, Linkon Medical Center, Taipei, Taiwan.
J Formos Med Assoc. 1998 Feb;97(2):139-42.
We reviewed 722 laparoscopically assisted vaginal hysterectomies performed between March 1991 and March 1996 at our institute, looking at the management of major complications. The indications for hysterectomy included adenomyosis, myoma uteri, intractable menorrhagia, endometriosis, and severe pelvic adhesion. During 1 to 6 years' follow-up, there were 12 (1.7%) major complications, comprising six bladder injuries, one iliac artery perforation, two bowel injuries, two cases of partial intestinal obstruction, and one pelvic abscess. Four complications were repaired successfully by laparotomy, six were repaired laparoscopically or vaginally, and two were treated conservatively. All the cases with visceral injuries were detected intraoperatively, therefore, adequate repair operations could be performed uneventfully. Early detection and treatment allow complications to be resolved more easily.
我们回顾了1991年3月至1996年3月间在我院进行的722例腹腔镜辅助阴式子宫切除术，观察主要并发症的处理情况。子宫切除术的指征包括子宫腺肌病、子宫肌瘤、难治性月经过多、子宫内膜异位症和严重盆腔粘连。在1至6年的随访中，发生了12例（1.7%）主要并发症，包括6例膀胱损伤、1例髂动脉穿孔、2例肠损伤、2例部分肠梗阻和1例盆腔脓肿。4例并发症通过开腹手术成功修复，6例通过腹腔镜或阴道修复，2例保守治疗。所有内脏损伤病例均在术中被发现，因此能够顺利进行充分的修复手术。早期发现和治疗使并发症更容易得到解决。
