Objective:To compare the intraoperative condition and short-term outcomes of vaginal hysterectomy(VH) and laparoscopic assisted vaginal hysterectomy(LAVH) for enlarged myomatous uterus. Methods:Fifty patients from Pek...Objective:To compare the intraoperative condition and short-term outcomes of vaginal hysterectomy(VH) and laparoscopic assisted vaginal hysterectomy(LAVH) for enlarged myomatous uterus. Methods:Fifty patients from Peking Union Medical College Hospital(PUMCH) were randomly assigned to two treatment groups:VH(n= 23) and LAVH(n= 27).All procedures were performed by a single senior surgeon to maintain homogeneity. Results:The baseline characteristics of the two groups were comparable.The operative time for LAVH was significantly longer than for VH(76.7±23.2 vs.57.6±23.5 min,P<0.05),and LAVH costs more money than VH(6,923.07±622.96 vs.5,974.46±1,408.08 RMB,P<0.05).Major complications,uterine weight and the length of hospital stay were comparable between VH and LAVH group.One case of VH was converted to LAVH due to adhesion. Conclusions:Compared with LAVH,VH is a time- and cost-saving operative technique for enlarged myomatous uterus.VH should be the primary method for uterine removal,but LAVH may have advantages when adhesion is present.展开更多
目的：探讨单孔腹腔镜辅助下阴式子宫全切除术及阴式子宫全切术在临床应用中的安全及有效性。方法选择2013年1月~2014年9月成都市第五人民医院妇科收治拟行子宫全切患者70例为研究对象，采用随机数字表法将其分为单孔腹腔镜辅助阴式组...目的：探讨单孔腹腔镜辅助下阴式子宫全切除术及阴式子宫全切术在临床应用中的安全及有效性。方法选择2013年1月~2014年9月成都市第五人民医院妇科收治拟行子宫全切患者70例为研究对象，采用随机数字表法将其分为单孔腹腔镜辅助阴式组和阴式组，每组各35例。单孔腹腔镜辅助阴式组患者采用经脐单孔腹腔镜辅助下阴式全子宫切除术，阴式组采用阴式全子宫切除术。分析比较两组患者年龄、体重指数、阴道分娩史、盆腔手术史及本次切除子宫原因、手术时间、出血量、子宫重量、术后即刻视觉模拟评分（VAS）、术后1、3、7 d VAS、术后排气时间、术后住院时间、住院费用、并发症情况及中转手术情况。结果阴式组术后即刻VAS评分、手术时间、术后排气时间及住院费用优于单孔腹腔镜辅助阴式组，差异均有高度统计学意义（P〈0.01）。阴式组术中并发症及中转开腹发生率明显高于单孔腹腔镜辅助阴式组，差异有统计学意义（P〈0.05）。单孔腹腔镜辅助阴式组术后并发症总发生率为8.57%，明显低于对照组的25.71%，差异有统计学意义（P〈0.05）。单孔腹腔镜辅助阴式组患者术后1、3、7 d VAS评分均显著低于阴式组，差异均有统计学意义（P〈0.05）。结论阴式子宫全切手术为经自然腔道手术，具有更微创的优点，但因安全的原因，单孔腹腔镜辅助阴式子宫切除手术更值得推广。展开更多
文摘Objective:To compare the intraoperative condition and short-term outcomes of vaginal hysterectomy(VH) and laparoscopic assisted vaginal hysterectomy(LAVH) for enlarged myomatous uterus. Methods:Fifty patients from Peking Union Medical College Hospital(PUMCH) were randomly assigned to two treatment groups:VH(n= 23) and LAVH(n= 27).All procedures were performed by a single senior surgeon to maintain homogeneity. Results:The baseline characteristics of the two groups were comparable.The operative time for LAVH was significantly longer than for VH(76.7±23.2 vs.57.6±23.5 min,P<0.05),and LAVH costs more money than VH(6,923.07±622.96 vs.5,974.46±1,408.08 RMB,P<0.05).Major complications,uterine weight and the length of hospital stay were comparable between VH and LAVH group.One case of VH was converted to LAVH due to adhesion. Conclusions:Compared with LAVH,VH is a time- and cost-saving operative technique for enlarged myomatous uterus.VH should be the primary method for uterine removal,but LAVH may have advantages when adhesion is present.
文摘目的：探讨单孔腹腔镜辅助下阴式子宫全切除术及阴式子宫全切术在临床应用中的安全及有效性。方法选择2013年1月~2014年9月成都市第五人民医院妇科收治拟行子宫全切患者70例为研究对象，采用随机数字表法将其分为单孔腹腔镜辅助阴式组和阴式组，每组各35例。单孔腹腔镜辅助阴式组患者采用经脐单孔腹腔镜辅助下阴式全子宫切除术，阴式组采用阴式全子宫切除术。分析比较两组患者年龄、体重指数、阴道分娩史、盆腔手术史及本次切除子宫原因、手术时间、出血量、子宫重量、术后即刻视觉模拟评分（VAS）、术后1、3、7 d VAS、术后排气时间、术后住院时间、住院费用、并发症情况及中转手术情况。结果阴式组术后即刻VAS评分、手术时间、术后排气时间及住院费用优于单孔腹腔镜辅助阴式组，差异均有高度统计学意义（P〈0.01）。阴式组术中并发症及中转开腹发生率明显高于单孔腹腔镜辅助阴式组，差异有统计学意义（P〈0.05）。单孔腹腔镜辅助阴式组术后并发症总发生率为8.57%，明显低于对照组的25.71%，差异有统计学意义（P〈0.05）。单孔腹腔镜辅助阴式组患者术后1、3、7 d VAS评分均显著低于阴式组，差异均有统计学意义（P〈0.05）。结论阴式子宫全切手术为经自然腔道手术，具有更微创的优点，但因安全的原因，单孔腹腔镜辅助阴式子宫切除手术更值得推广。
