腹腔镜大子宫切除术29例分析

Clinical analysis of hysterectomy of huge uterus for 29 cases under laparoscopy

目的探讨腹腔镜下大子宫切除术的适应症和手术技巧.方法对29例子宫超过12孕周的患者行腹腔镜辅助下阴式子宫切除术(LAVH),并观测术中平均失血量、平均手术时间、术后并发症和术后病率以及平均住院时间.结果29例全部在腹腔镜下完成,成功率100%.手术过程顺利,无1例膀胱,直肠损伤.手术时间为90～160 min(116.5±21.2 min),术中失血量100～250ml(165.6±50.3 ml),术后平均住院时间3.5 d.结论腹腔镜下大子宫切除术是安全可行的,并不会增加手术危险性和手术并发症,但必须掌握熟练的手术技巧并严格筛选病材.

Objective To explore the indication and the operative technique of hysterectomy of huge uterus under laparoscopy. Methods Laparoscopic-assisted vaginal huge hysterectomy（LAVH） was performed in 29 patients（size of uterus was over 12 pregnant, weeks）. Average quantity of bleeding during operation, average operation time, Dost-operative cornplications, post-operative morbidity rate and average stay were observed. Results All 29 cases were performed successfully under laparoscopy and successful rate was 100%. Operation was successful, none cystic or rectal injury. Operative time was 90～160 min（116.5±21.2 min）, quantity of bleeding was 100～250 ml（165.6±50.3 ml） and post-operative average stay was 3.5 days. Conclusion Hysterectomy of gigantic uterus under laparoscopy is safe and feasible, it will not increase surgical risk and surgical complications, but surgical techniques must grasped skillfully and eases are screened strictly.