LigaSure^(TM)在阴式子宫切除术中应用的临床分析

The clinical analysis of vaginal hysterectomy with LigaSure^(TM)

目的 探讨阴式子宫切除手术的操作技巧 ,提高手术水平。方法 借助器械LigaSureTM行阴式全子宫、附件切除术 (LigaSureTM组 ) 15 5例 ,与我院同期由同一医疗组医生以传统手术方式完成的阴式全子宫附件切除术 (传统组 ) 15 5例进行临床对照分析 ,探讨阴式子宫切除手术中的微创效果。结果 从环切阴道壁至缝闭阴道残端LigaSureTM组手术时间最长 4 0min、最短 8min ;术中出血量最多 115ml,最少 10ml;术后平均住院日5d ;术后 3个月复查阴道残端 ,无线头及肉芽生成 ,愈合良好 ,患者阴道分泌物正常。传统组手术时间最长 70min ,最短 15min ;术中出血量最多 5 0 0ml,最少 2 0ml;术后平均住院日 6 99d ;术后 3个月复查阴道残端 ,部分患者有线头及肉芽生成 ,间断出现血性分泌物或伴有异味 ,影响生活质量。比较手术时间、术中出血、术后并发症 (术后 3个月阴道残端情况 ) ,LigaSureTM组明显优于传统组 (P <0 0 5 )。结论 借助器械切除子宫附件使术中操作难度明显降低 ,简化了操作步骤 ,减少了副损伤 ,明显减少了术中出血及缩短了手术时间 ,术后恢复更快 ,达到了微创的目的 ,使阴式手术切除子宫更易掌握 ,便于广泛推广。

Objective To compare two approaches of vaginal hysterectomy, operation with LigaSure TM and with traditional technique.Methods The LigaSure TM System was used in vaginal hysterectomy, some and salpingo-oophorectomy, in 155 patients (LigaSure TM group) in our hospital. Another 155 patients undergone the same operation with the traditional technique (traditional group) by the same medical team served as controls. Results In the LigaSure TM group, the operation time ranged from 8 min to 40 min; and the operative blood loss was 10 ml to 115 ml; the mean postoperative hospitalization was 5 days; the vaginal stump was well healed with normal vaginal discharge 3 months after operation. In traditional group, the operation time was 15 to 70 minutes; the operative blood loss was 20 to 500 ml; the mean postoperative hospitalization was 6.99 days; sutures and granuation generation could be seen at the vaginal stump in some patients 3 months after operation, accompanied by abnormal vaginal discharge. The method with LigaSure TM System was superior to the traditional method as far as the operation time, the blood loss and the post-operative complications (P<0.05).Conclusions The application of the LigaSure TM System in vaginal hysterectomy (some and salpingo-oophorectomy) can make the operation easy and simple, reduce the avoidable hurt, decrease the loss of blood, shorten the operation time and shorten the postoperative recovery duration. LigaSure TM System provides a promising micro-invasive approach for vaginal hysterectomy and is worthy to be advocated.