腹腔镜辅助阴式子宫切除术98例分析

目的通过对９８例患者行腹腔镜辅助阴式子宫切除术（ＬＡＶＨ）分析,进一步探讨ＬＡＶＨ的适应证、手术要点及临床应用价值。方法自１９９５年２月至１９９７年２月,对９８例因各种良性妇科疾病而需行子宫全切除术的患者,采用ＬＡＶＨ术式。患者平均年龄５２岁（３８～６６岁）,术前子宫正常大小者３８例,子宫增大、小于孕１２周４４例,大于孕１２周１６例,其中有下腹手术史者２９例。结果９８例行ＬＡＶＨ中,２例中转开腹手术,中转率２．０％。平均手术时间１０６分钟（６０～２４０分钟）,出血量约５０～１５０ｍｌ。平均住院日为６天。结论ＬＡＶＨ拓宽了阴式子宫切除的适应证,可避免开腹、减少手术创伤

Laparoscopic assisted transvaginal hysterectomy

OBJECTIVE: To evaluate the indication, technical procedure and the clinical value of laparoscopic assisted trans vaginal hysterectomy (LAVH). METHODS: Ninety-eight patients suffered from various kinds of benign gynecological diseases underwent LAVH from Feb. 1995 to Feb. 1997. The mean age was 52 years (range 38-66), preoperative examination findings were 38 cases of normal uterine size, 60 of uterine enlargement (44 less than 12 week gestational size and 16 larger). Among these patients, 29 cases had a history of lower abdominal laparotomy. RESULTS: 2 out of the 98 cases were switched to laparotomy (2.0%). Mean operation time of LAVH was 106 min (range 60-240 min). The amount of blood loss was approximately 50-150 ml during operation, and the average hospitalization was 6 days. CONCLUSION: Laparoscopic assisted vaginal hysterectomy expands the indication of transvaginal hysterectomy, and avoids laparotomy and lessens injuries, shortens the hospitalization. It is a promising approach of hysterectomy and should be used widely.