腹腔镜巨大子宫全切术三种方式的临床评估

Clinical evaluation of laparoscopic total hysterectomy for large uterines by three different procedures

目的探讨三种不同方式在腹腔镜下巨大子宫全切术中的临床应用价值。方法回顾性分析126例子宫超过孕12周患者,其中超声刀组75例、超声刀+双极组21例、超声刀+结扎组30例,均行腹腔镜下全子宫切除术。结果所有病例全部在腹腔镜下完成子宫切除,无一例中转开腹,无一例手术并发症发生。手术时间分别为(118±18)、(110±14)、(121±16)m in,术中出血量分别为(232±88)、(149±48)、(160±87)m l,子宫重量分别为(374±102)、(363±51)、(370±58)g。结论腹腔镜下巨大子宫切除术是安全可行的,但必须有良好的手术器械和熟练的镜下操作技巧。

Objective To investigate the clinical value of laparoscopic total hysterectomy for large uterine by three different procedures. Methods One hundred and twenty, six patients with 12 weeks gestation uterine were analyzed retrospectively. All the cases were underwent laparoscopic total hysterectomy. Seventy -five cases were perfomed by using ultrasonic scalpel only,21 cases using ultrasonic scalpel and bipolar coagulation,30 cases usingultrasonic scalpel and suture. Results All patients were underwent of three groups, the operation time was （ 118 ±18 ） min, （ 110 ±14 ） min, （ 121 ±16 ） min respectively ; the blood loss was （232 ±88 ） ml, （ 149 ±48 ） ml （ 160 ±87 ） ml, respectively ; the weight of uterine was （ 374 ±102） g, （363 ±51 ） g and （ 310 ±58 ）.Conclusion With fine surgery appliance and advanced laproscopic surgical skills,laparoscopic total hysterectomy can be used for huge uterine safely.