腹腔镜全子宫切除术227例临床分析

Analysis of 227 cases of total laparoscopic hysterectomy

目的探讨应用腹腔镜行全子宫切除术的安全性及效果。方法对227例腹腔镜全子宫切除术患者的资料进行回顾性分析,患者平均年龄(48.57±3.31)岁(38～57岁),曾有下腹部手术史65例。妇科检查子宫正常大小15例,增大如孕6～7周大小21例,孕8～10周大小52例,孕11～12周大小113例,孕13～14周大小26例。结果227例患者均于腹腔镜下完成手术,无1例中转开腹,无1例手术并发症发生。手术时间平均(108.35±30.21)min,出血量平均(120.18±35.16)mL。术后住院时间平均(6.3±1.8)d。结论腹腔镜全子宫切除术为子宫切除提供了一种可选择的方法,只要合理选择适应证,熟悉盆腔解剖,熟练掌握腹腔镜操作技巧,腹腔镜全子宫切除术是安全可靠的。

[Objective] To investigate the effectiveness and safety of total laparoscopic hysterectomy （TLH）. [Methods] We retrospectively reviewed the clinical data of 227 cases of total laparoscopic hysterectomy, The average age of the patients was（48.57±3.31 ） years （38-57 years）, and 65 cases had a previous lower abdominal surgery. Pelvic examination revealed that the uterus were normal in 15 cases, and enlarged between 6 and 7 weeks gestational size in 21 cases, between 8 and 10 weeks gestational size in 52 cases, between 11 and 12 weeks gestational size in 113 cases, between 13 and 14 weeks gestational size in 26 cases. [Results] 227 cases were all operated successful by laparoscope. No case was converted to laparotomy. There were no complication in all cases. The mean operating time was （108.35±30.21） min. The average amount of blood loss was （120.18±35.16） mL during operation. The average hospital stay after operation was （6.3 ±1.8） days. [Conclusions] TLH is an alternative method for those women who need hysterostomy. TLH is safe and effective with suitable patients and familiar pelvic anatomy and skilled operative techniques.