悬吊式腹腔镜辅助阴式子宫切除术50例临床分析

Gasless laparoscopic assisted hysterectomy for moderate enlarged uterus:Report of 50 cases

[目的]探讨悬吊式腹腔镜辅助阴式大子宫切除术的安全性和可行性。[方法]对2005年7月~2009年7月50例子宫增大如12~20孕周子宫肌瘤、子宫肌腺症患者,行悬吊式腹腔镜辅助阴式子宫切除术（GLH组）。随机选取50例条件相同患者进行传统开腹全子宫切除手术（TAH组）,对两组手术时间、出血量、术后住院时间及术后镇痛情况进行分析。[结果]两组手术过程顺利,无中转开腹。与TAH组相比,GLH组术后住院时间短、术后镇痛者少（P〈0.05）,但手术时间长（P〈0.05）、术中出血量差异无显著性意义。[结论]对部分因良性病变≥12孕周子宫,术者具有熟练腹腔镜、阴式手术操作经验,悬吊式腹腔镜辅助阴式子宫切除术是安全可行的。

[ Objective ] To investigate the safety and feasibility of gasless laparoseopie assisted hysterectomy （GLH） for moderate enlarged uterus compared to total abdominal hysterectomy.[ Methods] A comparative study of GLH using an abdominal wall-lifting device （n=50） and total abdominal hysterectomy （TAH, n = 50 ） was carried out from July 2005 to July 2009. The uterine size was equivalent to 12 -20 gestational weeks. The operation time, blood loss, postoperative stay, and postoperative meperidine use were observed and analyzed. [ Results ] The operative time was （ 168 ±38） min and （ 112±29 ） min （ P 〈 0.05 ） for the GLH and TAH groups, respectively. Gasless laparoseopie hysterectomy cases had a shorter hospital stay [（5.5±1.2） days vs （7.3 ± 1.2） days,P 〈 0.05 respectively ]. Postoperative meperidine use was lower in GLH （P 〈 0.05 ）. Estimated blood loss was equal to GLH （P = 0. 216）. [ Conclusions] Gasless laparoseopic assisted hysterectomy is safe and feasible for moderate enlarged uterus （ ≥12 gestational weeks） in experieneed hands.