共查询到20条相似文献,搜索用时 15 毫秒
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Boosz A Lermann J Mehlhorn G Loehberg C Renner SP Thiel FC Schrauder M Beckmann MW Mueller A 《European journal of obstetrics, gynecology, and reproductive biology》2011,158(2):269-273
Objective
To compare re-operation rates and complication rates after total laparoscopic hysterectomy (TLH) and laparoscopy-assisted supracervical hysterectomy (LASH).Study design
Retrospective analysis of 867 women who underwent laparoscopic hysterectomy between January 2002 and December 2009 for benign gynaecological diseases. Total laparoscopic hysterectomy was performed in 567 women (TLH group) and laparoscopy-assisted supracervical hysterectomy was performed in 300 women (LASH group).Results
The women in the LASH group were significantly younger (45.6 years) than those in the TLH group (47.9 years) and the uteri removed with LASH were significantly heavier (326.4 g) than those removed with TLH (242.7 g). The rate of salpingo-oophorectomy was significantly lower in the LASH group. The overall re-operation rates were equivalent in the two groups. Two method-specific reasons for re-operations were identified. A method-specific procedure after LASH was extirpation of the cervical stump, which was performed in 2.7% of the women. Vaginal cuff dehiscence was a method-specific problem leading to secondary operation after TLH and was observed in 0.7% of the patients. No differences between the intraoperative and postoperative complication rates were observed, although there was a trend toward lower complication rates after LASH.Conclusions
There seem to be equivalent overall re-operation rates and complication rates after both hysterectomy procedures, making the two laparoscopic approaches for hysterectomy equivalent. 相似文献2.
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《Taiwanese journal of obstetrics & gynecology》2014,53(4):486-489
ObjectiveThis study aims to compare between operative outcomes of single-port-access laparoscopy-assisted vaginal hysterectomy (SPA-LAVH) and single-port-access total laparoscopic hysterectomy (SPA-TLH), further subdivided by vaginal cuff closure via laparoscopic suture (VCC-L) or via the vaginal route (VCC-V).Materials and methodsA custom-made port was used for single-port laparoscopy in 111 patients who underwent SPA-LAVH (n = 33), SPA-TLH with VCC-L (n = 35), and SPA-TLH with VCC-V (n = 43) during October 2009–October 2010. Records were reviewed retrospectively.ResultsA significant difference in the operating time was observed among the groups (p = 0.009). SPA-TLH with VCC-L took a significantly longer time to be performed (118.6 ± 41.8 minutes) than SPA-TLH with VCC-V (98.6 ± 21.3 minutes) or SPA-LAVH (102.0 ± 20.3 minutes). The decrease in hemoglobin level on the 1st day postsurgery was significantly smaller in case of SPA-LAVH (1.56 ± 0.97 g/dL, p = 0.005) compared with that in case of SPA-TLH with VCC-L (2.19 ± 0.95 g/dL) and SPA-TLH with VCC-V (2.24 ± 0.95 g/dL). No significant differences in other surgical outcomes were found.ConclusionSPA-TLH with laparoscopic vaginal suture required the longest operating time, and hemoglobin changes were smaller in the SPA-LAVH group than in the other groups. In patients undergoing SPA laparoscopy, we recommend the SPA-LAVH procedure. 相似文献
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Makoto Orisaka Tetsuji Kurokawa Ken-Ichi Shukunami Sanae Orisaka Mika T. Fukuda Akiko Shinagawa Shin Fukuda Noboru Ihara Hiroki Yamada Harumi Itoh Fumikazu Kotsuji 《European journal of obstetrics, gynecology, and reproductive biology》2007
Objective
The non-pregnant uterus shows wave-like activity (uterine peristalsis). This pilot study was intended to determine: (1) whether uterine peristalsis during the menstrual cycle is detectable by cine magnetic resonance imaging (MRI); (2) the effects of leiomyoma on uterine peristalsis.Study design
Mid-sagittal MRI was performed sequentially with T2-weighted single-shot fast spin-echo (SSFSE) in 3 normal ovulatory volunteers and 19 premenopausal women with uterine leiomyoma. Direction and frequency of movement of the junctional zone were evaluated using a cine mode display.Results
Junctional zone movement was identified in all subjects. Direction of uterine peristalsis in normal volunteers was fundus-to-cervix during menstruation, cervix-to-fundus during the periovulatory phase, and isthmical during the mid- and late-luteal phases. Abnormal peristaltic patterns were detected in three of five patients with uterine leiomyoma during menstruation and in the mid-luteal phase of the cycle, respectively.Conclusion
Cine MRI is a novel method for evaluation of uterine peristalsis. Results of this pilot study suggest that abnormal uterine peristalsis during menstruation and the mid-luteal phase might be one of the causes of hypermenorrhea and infertility associated with uterine leiomyoma. 相似文献6.
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《Taiwanese journal of obstetrics & gynecology》2020,59(4):565-569
ObjectiveWe aimed to compare the surgical outcomes between hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and laparoscopic total hysterectomy (LTH).Materials and methodsThis study is a retrospective chart analysis. From January 1, 2015, to December 31, 2017, a total of 183 patients of reproductive age with an indication for hysterectomy due to non-prolapsed and benign uterine diseases were enrolled. After exclusion, 20 patients were included in the vNOTES group, and 66 patients were included in the LTH group. Various post-operative surgical outcomes such as operative time, blood loss, uterus weight, a decrease in hemoglobin level on post-operative day one, post-operative pain scale, complications, length of hospitalization, and re-admission rate were measured.ResultsNo difference was observed between both groups regarding operative time, blood loss, uterine weight, a decrease in hemoglobin level on post-operative day one, complications, hospital stay, and re-admission rate. Patients in the vNOTES group had significantly less post-operative pain compared with those in the LTH group (p = 0.03).ConclusionsThe surgical outcomes of hysterectomy by vNOTES could be similar to those of LTH. Patients undergoing hysterectomy by vNOTES may have less post-operative pain compared with those undergoing LTH. However, the sample size was small, and the results need more evidence to confirm these findings. 相似文献
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Erian J El-Shawarby SA Hassan M Wissa I Chandakas S Hill N 《European journal of obstetrics, gynecology, and reproductive biology》2008,137(1):84-87
OBJECTIVE: To evaluate the safety and applicability of laparoscopic subtotal hysterectomy (LSH) using the plasma kinetic (PK) and lap loop systems as an alternative surgical approach in the management of uterine fibroids in women who have completed their families. STUDY DESIGN: Sixty-two consecutive LSH were performed during this prospective study from March 2003 to March 2005 at Princess Royal University Hospital, Kent, UK. RESULTS: All study patients had menorrhagia resistant to at least one form of therapy, with a mean duration of symptoms of 3.5 years. In addition, four patients had previous myomectomy. The mean number of fibroids removed was 2.7. The mean weight of the uterus was 141.9 g. The mean operative time was 46.8 min, and the mean blood loss was 126.6 mL. The overall perioperative complication rate was 4.8% with no visceral injury, or return to theatre. At follow-up, all patients were satisfied with surgery. CONCLUSION: The study describes the first application of the PK and Lap Loop systems in LSH for the surgical management of uterine fibroids in women in whom fertility is not an issue, and its findings suggest that this minimally invasive technique is a safe, and valid alternative. Larger adequately-powered studies are however still required. 相似文献
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Demir A Bige O Saatli B Solak A Saygili U Onvural A 《Archives of gynecology and obstetrics》2008,277(4):325-330
Objective The aim of this study was to evaluate the level of tissue trauma after laparoscopic and total laparoscopic hysterectomy with
retroperitoneal lateral transsection of uterine vessels using ligasure as compared with abdominal hysterectomy.
Study design A total of 45 women with various indications for hysterectomy were randomized into laparoscopic hysterectomy, total laparoscopic
hysterectomy and abdominal hysterectomy. Laparoscopic and total laparoscopic hysterectomy with retroperitoneal lateral transsection
of uterine vessels was performed by four-puncture laparoscopy and pre-, postoperative and postoperative 24th hour levels of
interleukin-6 (IL-6) and C-reactive protein (CRP), the mean operative time, drop in hemoglobin concentration, weight of removed
uterus, VAS scores, hospitalization period and major and minor operative complications were analyzed prospectively.
Results CRP and IL-6 levels were significantly higher in the abdominal hysterectomy group compared to either laparoscopy groups at
the postoperative 24th hour. There were no significant differences in the levels of CRP and IL-6 between the two laparoscopy
groups. The longest operative times were observed in the total laparoscopic hysterectomy group.
Conclusion Laparoscopic surgery causes less tissue trauma than the conventional open surgery; however, we observed no difference between
the laparoscopic hysterectomy groups concerning the postoperative inflammatory response. We may prefer laparoscopic hysterectomy
instead of total laparoscopic hysterectomy under suitable conditions, since laparoscopic hysterectomy causes the same level
of tissue trauma as total laparoscopic hysterectomy, but has the advantage of a significantly shorter operative time. Meanwhile,
hysterectomy done by laparoscopy with retroperitoneal lateral transsection of uterine vessels using ligasure is an effective
and safe procedure. 相似文献
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Johannes Lermann Lothar Häberle Sabine MerkKathrin Henglein Matthias W. BeckmannAndreas Mueller Grit Mehlhorn 《European journal of obstetrics, gynecology, and reproductive biology》2013
Objective
The advantages of the various methods used for hysterectomy are currently a topic of debate, and there is particular controversy over whether the cervix should be left in situ or not. The aim of this study was to compare the prevalence of hypoactive sexual desire disorder (HSDD) after five different hysterectomy procedures.Study design
The Brief Profile of Female Sexual Function (B-PFSF) score was measured to compare postoperative prevalence of HSDD after the different surgical procedures. The questionnaire was sent to 590 women who had undergone hysterectomy between 2002 and 2007 for benign conditions. The following procedures were performed: abdominal hysterectomy (AH), vaginal hysterectomy (VH), laparoscopy-assisted vaginal hysterectomy (LAVH), laparoscopic supracervical hysterectomy (LASH), and total laparoscopic hysterectomy (TLH).Results
A total of 304 questionnaires returned and 258 were found to be eligible for analysis. The mean follow-up intervals were 2 years for women after LASH and TLH and 3 years for women after AH, VH, and LAVH. The women in the AH group were significantly older than those in the LASH group, and the women in the VH group were significantly older than those in the LASH or TLH groups. The median B-PFSF score was highest at 26 in women after LASH, 25 in women after TLH, 23 in women after LAVH, 23.5 in women after VH, and 21 in women after AH. There were no statistically significant differences between the groups.Conclusions
No differences were observed using the B-PFSF score with regard to the prevalence of HSDD after hysterectomy, irrespective of the surgical technique used. 相似文献14.
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Sara Y. Brucker Florin-Andrei Taran Sandra Bogdanyova Sandra Ebersoll Christian W. Wallwiener Birgitt Schönfisch Bernhard Krämer Harald Abele Felix Neis Christof Sohn Stephanie Gawlik Diethelm Wallwiener Markus Wallwiener 《Archives of gynecology and obstetrics》2014,290(6):1141-1149
Purpose
To compare patient-reported quality-of-life and sexual function outcomes in women after laparoscopic supracervical hysterectomy (LSH) or total laparoscopic hysterectomy (TLH) for benign uterine disease.Methods
Out of a cohort of 1,952 patients from a previous implementation study of LSH and TLH, 1,886 patients who had not undergone intraoperative conversion to laparotomy or were ineligible for other reasons were invited by mail to participate in this prospective, questionnaire-based follow-up study.Results
Of the 915/1,952 (48.5 %) survey respondents included in the analysis, 788 (86.1 %) and 127 (13.9 %) had undergone LSH or TLH, respectively. Women undergoing LSH reported significantly lower pain levels (p = 0.037) and faster partial (p = 0.015) and complete (p < 0.001) resumption of normal daily activities compared to those undergoing TLH. As regards sexual function, women undergoing LSH resumed sexual activity significantly sooner (p = 0.018), rated sexual desire as higher (p = 0.023), and reported more frequently that their sexual life had improved postoperatively (p = 0.008) than did women undergoing TLH.Conclusions
Women undergoing LSH for benign uterine disease may have better outcomes regarding certain quality-of-life and sexual function parameters than women undergoing TLH for benign uterine disease. 相似文献16.
子宫血管缝扎术在腹腔镜下全子宫切除术中应用的临床分析 总被引:6,自引:0,他引:6
目的 探讨腹腔镜下全子宫切除术中子宫血管处理方法。方法 回顾性分析89例腹腔镜下全子宫切除术中子官动静脉处理方法。分析宫旁缝扎组的手术时间、术中出血量及术后病率,并与子宫动脉游离结扎组及腹腔镜联合阴式子宫切除术组进行比较。结果 子宫血管缝扎组与血管游离后处理组患者的手术时间、术后出血量及术后病率比较差异无显著性(P〉0.05);子宫血管缝扎组与腹腔镜联合阴式子宫切除术组的手术时间及术后病率比较差异无显著性(P〉0.05),但子宫血管缝扎组出血量明显减少(P〈0.05)。结论 宫旁缝扎子宫动静脉后电凝切断子宫血管及主韧带,需要的器械简单,操作简便,手术野清晰,容易推广,在腹腔镜子官切除术中有较大的临床应用价值。 相似文献
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Jan Drahonovsky Lucia Haakova Michal Otcenasek Ladislav Krofta Eduard Kucera Jaroslav Feyereisl 《European journal of obstetrics, gynecology, and reproductive biology》2010
Objectives
To compare the clinical results of three minimally invasive hysterectomy techniques: vaginal hysterectomy (VH), laparoscopically assisted vaginal hysterectomy (LAVH), and total laparoscopic hysterectomy (TLH).Study design
A prospective, randomized study was performed at a tertiary care center between March 2004 and October 2005. A total of 125 women indicated to undergo hysterectomy for benign uterine disease were randomly assigned to three different groups (40 VH, 44 LAVH, and 41 TLH). Outcome measures, including operating time, blood loss, rate of complications, inflammatory response, febrile morbidity, consumption of analgesics, and length of hospital stay, were assessed and compared between groups.Results
Vaginal hysterectomy had the shortest operating time (66 min) and smallest drop in hemoglobin. However, there were technical problems with salpingo-oophorectomy from the vaginal approach (3/20 cases) and this group had a significantly higher rate of febrile complications (20%) compared to LAVH (2.3%) and TLH (7.3%). The increase in inflammatory markers was higher in vaginal hysterectomy patients. Laparoscopically assisted vaginal hysterectomy had an acceptable operating time (85 min), a low complication rate, lack of severe post-operative complications, and the lowest consumption of analgesics. However, it had the highest blood loss. Total laparoscopic hysterectomy had the longest operating time (111 min) and severe complications occurred only in this group. Conversions to another hysterectomy method occurred in all three groups, most of these conversions were to LAVH.Conclusions
Based on our results, in women with non-malignant disease of the uterus, LAVH and VH seem to be the preferred hysterectomy techniques for general gynecological surgeons. Vaginal hysterectomy had the shortest operating time and least drop in hemoglobin, making it a suitable method for women for whom the shortest duration of surgery and anesthesia is optimal. LAVH is a versatile procedure, combining the advantages of both the vaginal and laparoscopic approach, and is preferable in cases when oophorectomy is required. Total laparoscopic hysterectomy did not appear to offer any significant benefits over the other two methods and should be strictly indicated in women where neither VH nor LAVH are feasible and should only be performed by very experienced laparoscopists. 相似文献19.
Tong Wang Gun Oh Chong Nae Yoon Park Dae Gy HongYoon Soon Lee 《European journal of obstetrics, gynecology, and reproductive biology》2012
Objective
To compare the perioperative surgical outcomes and complication rates between single-port total laparoscopic hysterectomy and conventional four-port total laparoscopic hysterectomy.Study design
Between June 2009 and April 2011, 56 patients underwent total laparoscopic hysterectomy. Of these 56 patients, 28 underwent single-port (Octoport™) total laparoscopic hysterectomy and 28 underwent conventional four-port total laparoscopic hysterectomy. We analyzed the following parameters for all the patients: age, body mass index, operative time, blood loss, change in hemoglobin level, vaginal stump suture time and length of hospital stay.Results
The general characteristics of the patients were similar in both groups. There were no statistically significant differences in blood loss, hemoglobin change, length of postoperative hospital stay and complication rate. However, the mean operative time of the single-port group was significantly longer than that of the four-port group (93.5 ± 24.0 min vs. 78.7 ± 17.4 min; P = 0.011). The operative time for vaginal stump suture was profoundly decreased with experience in the single-port group.Conclusion
With the exception of operative time, the surgical outcomes and incidence of complications of the single-port group were comparable to those of the four-port group. However, the operative time decreased in the single-port group with increasing experience. 相似文献20.
目的 观察米非司酮对子宫肌瘤组织病理学的影响,探讨其使肌瘤体积缩小的机制。方法60例子宫肌瘤患者随机分为治疗组和对照组,其中治疗组21例患者手术前每天服用米非司酮10mg,共3个月,分别于治疗前后B超测定最大肌瘤三维经线判定肌瘤体积变化;对照组39例患者术前未接受任何激素治疗。两组患者术后行组织切片HE染色,观察两组肌瘤组织病理学的改变。结果 治疗组肌瘤组织退行性变的程度与对照组相比差异有显著性(P<0.05);而治疗后有效组与无效组在病理改变上差异无显著性(P>0.05)。结论米非司酮治疗后肌瘤组织退行性变的程度增加,可能与血供减少有关,是肌瘤缩小的原因之一。 相似文献