悬吊式腹腔镜辅助阴式子宫切除术50例临床分析

[目的]探讨悬吊式腹腔镜辅助阴式大子宫切除术的安全性和可行性。[方法]对2005年7月~2009年7月50例子宫增大如12~20孕周子宫肌瘤、子宫肌腺症患者,行悬吊式腹腔镜辅助阴式子宫切除术（GLH组）。随机选取50例条件相同患者进行传统开腹全子宫切除手术（TAH组）,对两组手术时间、出血量、术后住院时间及术后镇痛情况进行分析。[结果]两组手术过程顺利,无中转开腹。与TAH组相比,GLH组术后住院时间短、术后镇痛者少（P〈0.05）,但手术时间长（P〈0.05）、术中出血量差异无显著性意义。[结论]对部分因良性病变≥12孕周子宫,术者具有熟练腹腔镜、阴式手术操作经验,悬吊式腹腔镜辅助阴式子宫切除术是安全可行的。

Gasless laparoscopic assisted hysterectomy for moderate enlarged uterus:Report of 50 cases

[Objective] To investigate the safety and feasibility of gasless laparoscopic assisted hysterectomy(GLH) for moderate enlarged uterus compared to total abdominal hysterectomy.[Methods] A comparative study of GLH using an abdominal wall-lifting device(n=50) and total abdominal hysterectomy(TAH,n=50) was carried out from July 2005 to July 2009.The uterine size was equivalent to 12～20 gestational weeks.The operation time,blood loss,postoperative stay,and postoperative meperidine use were observed and analyzed.[Results] The operative time was(168±38) min and(112±29) min(P<0.05) for the GLH and TAH groups,respectively.Gasless laparoscopic hysterectomy cases had a shorter hospital stay [(5.5±1.2) days vs(7.3±1.2) days,P<0.05 respectively].Postoperative meperidine use was lower in GLH(P<0.05).Estimated blood loss was equal to GLH(P=0.216).[Conclusions] Gasless laparoscopic assisted hysterectomy is safe and feasible for moderate enlarged uterus(≥12 gestational weeks) in experienced hands.