腹腔镜子宫切除术式评价

Laparoscopic Hysterectomy: An Analysis of 82 Cases

目的 分析评价四种腹腔镜子宫切除术在妇科的临床应用价值。方法 1999年 12月～ 2 0 0 4年7月 ,对 112例良性疾病有子宫切除指征者 ,采用全麻及四种不同的腹腔镜子宫切除术式 :腹腔镜辅助的阴式子宫切除术 (LAVH) ,全腹腔镜子宫切除术 (TLH) ,腹腔镜次全子宫切除术 (LSH) ,腹腔镜筋膜内宫颈上子宫切除术 (CISH) ;镜下主要使用器械为强生超声刀和双极电凝器。结果 腹腔镜子宫切除占同期妇科良性疾病子宫切除的 5 .0 2 % ,112例手术成功 ,术后发生出血和下肢神经损伤各一例 ,并发症发生率 1.79% ;早期术式以LAVH为多 ,目前以LAVH和CISH为主 ,四种术式并存。结论 腹腔镜子宫切除术在妇科的临床应用前景广阔 ,四种术式各有利弊 ,以LAVH和CISH的使用较广 。

Objective To analyze clinical applicability of four surgical techniques of laparoscopic hysterectomy.Methods A sample of 112 cases was selected; all of the patients suffered from benign diseases and were treated with hysterectomy from December of 1999 to July of 2004, with general anesthesia and one of the following four techniques of laparoscopic hysterectomy: LAVH, TLH, LSH, and CISH. Major equipment used in laparoscopic procedures included an ultrasound scalpel and bipolar coagulation.Results Laparoscopic hysterectomy comprised 5.02% of all surgeries among patients who had suffered from benign diseases and were treated with hysterectomy. The 112 surgeries were performed successfully, with a complication rate of 1.79%. Most of the complications were associated with the technique of LAVH in the early stage of application; currently, complications were mainly related to LAVH and CISH.Conclusion Laparoscopic hysterectomy can be applied extensively in gynecologic surgeries. Each of the four techniques has its pros and cons with LAVH and CISH capable of being used more extensively. The complementary use of these two techniques can meet the basic needs of hysterectomy.