腹腔镜辅助阴式子宫切除术38例分析

Laparoscopic assisted transvaginal hysterectomy

目的 :通过对 38例患者行腹腔镜辅助阴式子宫切除术 (LAVH)后分析LAVH的适应证、手术要点和并发症的预防。方法 :38例因各种妇科良性疾病需行子宫全切除术的患者 ,采用LAVH术式。患者平均年龄 5 3岁 (36～ 6 5岁 ) ,术前子宫正常大小者 2例 ,子宫增大≤ 12孕周者 2 3例 ,>12孕周 13例。有下腹部手术史 4例。结果 :38例LAVH中有 37例顺利完成 ,1例因膀胱损伤行开腹膀胱修补术。平均手术时间 112(6 8～ 2 2 0 )min ,术中出血量 110 (4 0～ 2 30 )ml。平均住院 4d。结论 :LAVH拓宽了阴式子宫切除的适应证 ,可避免开腹 。

Objective:To evaluate the indication,technical precedure and the clincal value of laparoscopic assist-ed transvaginal hysterectomy(LAVH).Methods:Thirty-eight patients who suffered from various kinds of benign gyneco-logical diseases were performed LAVH。The mean age was53years(rang36-65years)old,preoperative examination find-ings were2cases of normal uterine size,36of uterine enlargement(23less than12week gestationnal size and13larger).Among these patients,4cases had undergone lower abdominal laparotomy.Results:1out of37cases were switched to lap-oratomy.Mean operation time of LAVH was112(range68-220)min.The amount of blood loss was approximately110(range40-230)ml during operation,and the average hospitalization was4days.Conclusions:Laparoscopic assisted vagi-nal hysterectomy expands the indication of transvaginal hysterectomy,and avoids laparotomy and lessens injures,shortens the hospitalization.It is a promising approach of hysterectomy and should be used widely.