阴式子宫切除术与腹腔镜辅助下阴式子宫切除术的应用探讨

目的探讨阴式子宫切除术(transvaginalhysterectomy,TVH)与腹腔镜辅助下阴式子宫切除术(laparoscopicassistedvaginalhysterectomy,LAVH)两者应用指征及特点。方法回顾性分析了46例TVH和54例LAVH病例的临床资料。结果LAVH组的手术成功率、术后住院时间及并发症发生率、适应证均显著优于TVH组;而TVH组的手术时间较短、成本-效果比明显优于LAVH组。结论LAVH显著扩大了经阴道子宫切除术的适应证,使部分需要经腹子宫切除术(transabdominalhysterectomy,TAH)的病人避免了开腹手术,其较TVH更为优越;但TVH组成本-效果比显著优于LAVH组,从经济学角度出发如存在适应证,TVH手术仍可作为首选术式。

Clinial study of laparoscopic assisted vaginal hysterectomy versue transvaginal hysterectomy

Objective] To compare the clinical result of laparoscopic assisted vaginal hysterectomy (LAVH) with transvaginal hysterectomy (TVH). Methods] Clinical material of 54 patients who had been put LAVH was analyzed with retrospective methods and compared with clinical material of 46 cases of TVH. Results] The rate of operative success, the hospitalized time, the occurrence rate of complications and indications were sigingicantly lower for group TVH than that of group LAVH. The operation time and the cost-effectiveness ratio (CER) were significantly longer and higher for group TVH than that of group LAVH. Conclusions] LAVH may replace transabdominal hysterectomy (TAH) in large part of patients who require a hysterectomy and have contraindications to vaginal hysterectomy. The group TVH is superior to the LAVH in the CER for treatment of benign gynecological diseases referred for hysterectomy.