摘要
目的比较腹腔镜辅助阴式子宫切除术(laparoscopically assisted vaginal hysterectomy,LAVH)与开腹全子宫切除术(trans-abdominal hysterectomy,TAH)治疗大子宫的临床效果。方法对我院2003年7月～2008年12月117例大子宫(>12孕周)行LAVH与110例TAH的手术时间、术中出血量、术后恢复情况进行对比分析。结果TAH组手术时间(109±27)min明显短于LAVH组(130±22)min(t=-6.441,P=0.000),术中出血量LAVH组(121±70)ml显著少于TAH组(141±73)ml(t=-0.903,P=0.368)。排气时间TAH组(45±13)h明显长于LAVH组(24±6)h(t=15.778,P=0.000),术后住院时间TAH组(7±2)d显著长于LAVH组(5±2)d(t=7.530,P=0.000)。LAVH组术后3个月随访110例,阴道残端息肉5例,与肠线不吸收有关;TAH组术后3个月随访105例,阴道残端息肉1例。此6例给予摘除息肉后痊愈。结论与TAH相比,LAVH住院时间少,并发症低,即使是大子宫,对许多患者也是安全可行的。
Objective To compare the efficacy of laparoscopic-assisted vaginal hysterectomy （LAVH） and trans-abdominal hysterectomy （TAH） for large uterus. Methods Between 2003 July and 2008 December, 117 patients with large uterus （ 〉 12 gestational-week uterus） were treated in our hospital by LAVH. The operation time, intraoperative blood loss, and postoperative recovery of the patients were compared to another 110 cases that underwent TAH. Results The operation time in the TAH group was significantly shorter than that in the LAVH group [ （ 109 ± 27） min vs （ 130 ± 22） min, t = - 6. 441, P = 0. 000 ]. During the operation, the LAVH group had a mean of （121 s-70） ml blood loss, which was significantly lower than that in the TAH group [ （141 ±73） ml, t = -0. 903, P = 0. 368]. After the operation, the patients in the TAH group had longer recovery time for gastrointestinal function and longer hospital stay than those in the LAVH group [ （45 ± 13） h vs （24 ±6） h, t = 15. 778, P =0.000; and （7 ± 2） d vs （5 ± 2） d, t = 7. 530, P = 0. 000 ]. Conclusions Compared to TAH, LAVH results in shorter hospital stay and fewer postoperative complications. It is a feasible and safe treatment for large uterus.
出处
《中国微创外科杂志》
CSCD
2009年第10期881-883,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
腹腔镜辅助阴式子宫切除术
开腹子宫切除术
大子宫
Laparoscopic-assisted vaginal hysterectomy
Trans-abdominal hysterectomy
Large uterus
