LigaSure与超声刀在全腹腔镜子宫切除术中的应用

Ligasure and Ultracision in Total Laparoscopic Hysterectomy

目的探讨LigaSure与超声刀在全腹腔镜子宫切除术中的应用价值。方法回顾分析2002年1月～2006年12月225例腹腔镜全子宫切除术的临床资料,其中应用LigaSure手术152例、应用超声刀手术73例。结果LigaSure组手术时间为(104.9±29.2)min,显著短于超声刀组(152.4±46.6)min(t=-9.329,P=0.000);LigaSure组术中出血量为(32.9±14.9)ml,显著少于超声刀组(126.4±12.1)ml(t=-46.710,P=0.000)。2组均无中转开腹,无术中副损伤及术后并发症。结论采用LigaSure和超声刀行腹腔镜子宫切除术均安全、可靠。LigaSure在处理子宫血管方面更具有优势,超声刀在打开膀胱反折和离断主韧带方面效果理想。

Objective To explore the value of Ligasure and Ultracision in total laparoscopic hysterectomy （TLH）. Methods From January 2002 to December 2006, totally 225 patients received total laparoscopic hysterectomy in our hospital. Among the cases, Ligasure was used in 152 patients, and Ultracision were employed in 72. The clinical data of the patients were reviewed. Results The mean operation time in the Ligasure group was significantly shorter than that in the Ultracision group [（104.9±29.2） min vs. （152.4±46.6） min, t= -9.329, P =0.000]. And the mean blood loss of the Ligasure group was significantly less than that in the other group [（32.9±14.9） ml vs. （126.4±12.1） ml, t= -46.710, P =0.000]. In both the groups, no patient was converted to open surgery or developed complications or surgical injuries. Conclusions Both Ligasure and Uhracision are safe and effective for total laparoscopie hysterectomy. Ligasure is superior in the management of uterine vessels, while the Ultracision is more effective in opening the vesicle and separating the cardinal ligament.