Summitt R L, Stovall T G, Steege J F, Lipscomb G H
Department of Obstetrics and Gynecology at The University of Tennessee, Memphis 38103, USA.
Obstet Gynecol. 1998 Sep;92(3):321-6.
To compare intraoperative and postoperative outcomes between laparoscopically assisted vaginal hysterectomy and abdominal hysterectomy among patients who are not eligible for vaginal hysterectomy.
Study subjects were randomly assigned to undergo laparoscopically assisted vaginal hysterectomy or standard abdominal hysterectomy. Intraoperative and postoperative management was similar for each group. Surgical characteristics, complications, length of hospital stay, charges, and convalescence were analyzed.
Sixty-five women at three institutions underwent laparoscopically assisted vaginal hysterectomy (n = 34) or abdominal hysterectomy (n = 31). Three patients in the laparoscopic group required conversion to abdominal hysterectomy. Mean operating time was significantly longer for laparoscopically assisted vaginal hysterectomy (179.8 versus 146.0 minutes). There were no differences in blood loss or incidence of intraoperative complications. There was a higher incidence of wound complications in the abdominal hysterectomy group, but no significant difference in the frequency of postoperative complications. Laparoscopically assisted vaginal hysterectomy required a significantly shorter mean hospital stay (2.1 days) and convalescence (28.0 days) than abdominal hysterectomy (4.1 days and 38.0 days, respectively). There were no significant differences in mean hospital charges between the study groups (laparoscopic $8161, abdominal $6974).
Except for operating time, there are no differences between laparoscopically assisted vaginal hysterectomy and abdominal hysterectomy regarding intraoperative characteristics among abdominal hysterectomy candidates. Postoperatively, laparoscopically assisted vaginal hysterectomy requires a shorter hospital stay and convalescence. Hospital charges are similar between the procedures. A larger number of cases will help determine the indications for laparoscopically assisted vaginal hysterectomy.
比较在不适合行阴式子宫切除术的患者中，腹腔镜辅助阴式子宫切除术与腹式子宫切除术的术中及术后结果。
研究对象被随机分配接受腹腔镜辅助阴式子宫切除术或标准腹式子宫切除术。每组的术中及术后管理相似。分析手术特征、并发症、住院时间、费用及康复情况。
三个机构的65名女性接受了腹腔镜辅助阴式子宫切除术（n = 34）或腹式子宫切除术（n = 31）。腹腔镜组有3名患者需要转为腹式子宫切除术。腹腔镜辅助阴式子宫切除术的平均手术时间显著更长（179.8分钟对146.0分钟）。术中失血量及术中并发症发生率无差异。腹式子宫切除术组伤口并发症发生率更高，但术后并发症发生率无显著差异。与腹式子宫切除术（分别为4.1天和38.0天）相比，腹腔镜辅助阴式子宫切除术的平均住院时间（2.1天）和康复时间（28.0天）显著更短。研究组之间的平均住院费用无显著差异（腹腔镜组8161美元，腹式组6974美元）。
对于适合腹式子宫切除术的患者，除手术时间外，腹腔镜辅助阴式子宫切除术与腹式子宫切除术在术中特征方面无差异。术后，腹腔镜辅助阴式子宫切除术需要更短的住院时间和康复时间。两种手术的住院费用相似。更多病例将有助于确定腹腔镜辅助阴式子宫切除术的适应证。
