腹腔镜下子宫次全切除术的临床价值

Clinical value of laparoscopic supracervical hysterectomy

目的 探讨腹腔镜下子宫次全切除的临床价值。方法 对 5 3例因诊断为子宫肌瘤 (43例 )、子宫腺肌症 (6例 )及子宫内膜增殖症 (4例 )的患者行腹腔镜下子宫次全切除术 ,对同时期 6 1例有同样适应症的患者行腹式子宫次全切除手术。比较两组病人术中、术后情况。结果 两组病人的手术时间、术中出血量无显著性差异 ,腹腔镜下子宫次全切除术的手术时间与子宫大小有关 ,术中出血量与手术时间及子宫大小无关 ;行腹腔镜下子宫次全切除术的病人手术后疼痛的发生率明显减少 ,术后住院时间缩短。无手术并发症发生。结论 腹腔镜下子宫次全切除术虽不能完全代替腹式子宫次全切除术 ,但是是一种安全、可靠 。

Objective To investigate the clinical value of laparoscopic supracervical(subtotal) hysterectomy (LSH). Methods Fifty three diagnosed patients including 43 with uterine myoma, 6 adenomyosis and 4 endometrial hyperplasia received LSH and another 61 women with similar indications were operated with abdominal subtotal hysterectomy (ASH) at same period. The patient condition during and after operation in the 2 groups was compared and analyzed. Results No significant difference was found on average operating time and estimated blood loss of the 2 groups. In the cases of LSH, there was significant correlation between operating time and uterine weight, and the estimated blood loss had no relation with operating time and uterine weight. Postoperative pain and hospitalized time were decreased in LSH group compared with those of ASH group. No major complication occurred in LSH group. Conclusion Although LSH cannot replace ASH completely, it is a safe and reliable method of hysterectomy and can be performed widely.