下腹手术史患者腹腔镜辅助阴式子宫切除术近远期并发症观察

The effect of the laparoscopic assisted vaginal hysterectomy in patients with history of abdominal operation

目的观察下腹部手术史患者行腹腔镜辅助阴式子宫切除术(LAVH)的近远期并发症情况。方法回顾分析本院2008年1月至2011年6月,曾有下腹部手术史的95例LAVH及107例经腹全子宫切除术(TAH)病例资料。比较两种手术的术中大出血、邻近器官损伤、术后全身炎症反应综合征(SIRS)、腹部切口愈合不良、下肢静脉栓塞、盆腔感染、残留卵巢综合征等近远期并发症发生情况。结果 LAVH组在术后全身炎症反应综合征、腹部切口愈合不良方面的发生率低于TAH组,差异有显著性(P<0.05)。在术中大出血、邻近器官损伤、下肢静脉栓塞、盆腔感染、残留卵巢综合症方面,两组差异无显著性(P>0.05)。结论 LAVH是下腹手术史患者可行的手术方式,但要根据术者经验及患者具体情况而行。

Objective To observe the short term and long term complications of the laparoscopic assisted vaginal hysterectomy （LAVH） in patients with history of abdominal operation. Methods 95 cases of LAVH and 107 cases of TAH with history of abdominal operation from Jan 2008 to Jun 2011 in my hospital were retrospective analyzed. The short term and long term complications occurrence in the two groups were compared, such as major bleeding during the operation, the adjacent organ injury, postoperative systemic inflammatory response syndrome （SIRS）, poor abdominal inci- sion healing, extremity venous thrombosis, pelvic infection, the residual ovary syndrome. Results In the LAVH group, the incidence of SIRS, ab- dominal incision healing badly, was lower than in the TAH group （P〈0.05）. The incidence of the major bleeding during the operation, the adjacent or- gan injury, extremity venous thrombosis, pelvic infection, the residual ovary syndrome in the two groups had no significant difference （P〉0.05）. Conclusion LAVH can be performed in patients with history of abdominal operation, according to the operation experience of the surgeon and the specific situation of patients.