腹腔镜和经腹大子宫全切术的比较

Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy for Large Uterus

目的:通过比较腹腔镜下全子宫切除术(total laparoscopic hysterectomy,TLH)和经腹全子宫切除术(total abdominalhysterectomy,TAH),探讨大子宫行TLH的安全性和可行性。方法:收集100例大子宫(子宫≥12周)准备子宫切除的患者,50例行TLH(TLH组);50例行TAH(TAH组),比较2组患者术中与术后并发症发生率、手术时间、术中出血、术后血红蛋白改变、红细胞容积改变。结果:50例行TLH者,无一例中转开腹,术中、术后并发症2组间无显著差异(P>0.5),手术时间TLH组较TAH组长(P<0.01);围术期血红蛋白(Hb)和红细胞容积(Hct)在两组间无显著差异;术中出血量TLH组较TAH组多(P<0.01)。结论:大子宫行TLH是安全可行。

To investigate the effectiveness and safety of total laparoscopic hysterectomy（TLH） for large uterus comparing with total abdominal hysterectomy（TAH）. Methods： A total of 100 patients with enlarged uterus have been involved in this study. 50 cases of them underwent TLH （TLH group） and the other 50 cases underwent TAH （TAH group）, whether or not adnexectomy was performed. Intraoperative and postoperative complication rates, operative time, amount of blood loss, perioperative hernatocrit and hemoglobin concentrations were compared between the two groups. Results： Of the 50 cases who underwent TLH, no case was converted to laparotomy. No difference was found in preoperative and postoperative complication rates between the two groups. The amount of blood loss in the TLH group was significantly more than the TAH group （P〈0.01）, and the operative time in the TLH group was significantly longer than that in the TAH group （P〈0.01）. The two groups did not differ significantly in preoperative and postoperative hematocrit and hemoglobin concentration （P〈0. 05）. Conclusions： TLH for large uterus is safe.