腹腔镜辅助阴式大子宫切除术与开腹大子宫切除术的对比分析

Clinical study of laparoscopically assisted vaginal hysterectomy and total abdominal hysterectomy for treatment of large uterus

目的对比分析腹腔镜辅助阴式大子宫切除术与开腹大子宫切除术的临床疗效。方法 2007年1月～2012年8月,回顾性对比研究80例因子宫肌瘤等良性疾病致子宫增大超过孕3个月大小的患者行腹腔镜辅助阴式子宫切除术,与同期行开腹子宫切除术80例患者。两组患者年龄、疾病种类、子宫体积大小、腹部手术史等情况差异无统计学意义(P>0.05)。结果两组手术均顺利完成。LAVH组手术时间、术中出血量、术后住院时间、下床活动时间,肛门排气时间及术后镇痛例数均明显少于TAH组,差异有统计学意义(P<0.01)。结论腹腔镜辅助阴式大子宫切除术是安全可行的,但医师应具备丰富的腹腔镜手术经验及技巧。

Objective To compare the clinical relevant outcomes between laparoscopicaIiy assisted vaginal hysterectomy and total abdominal hysterectomy for large uterus,explore the reliability and safety of the surgical characteristics about the resection the large uterus. Methods A retrospective analysis was performed between January 2007 and Aug 2012. All patients were benign lesions uterus more than 12 weeks gestation. 80 cases were used to LAVH,and 80 cases were used to TAH. Results In laparoscopic surgery group,operation time,bleeding volume during surgery were less,post-operation body temperature recovered earlier,patients ate food earlier and exsufflation faster,active earlier,hospital stay time was shorter.All patients＇wound healing was good.There was significance statistical diference（P （ 0.O1）,compared with the control group. Conclusion Laparoscopically assisted vaginal hysterectomy for large uterus is safe and feasible,but operators should have plentiful experience of laparoscopic procedures and skills under laparoscopy.