腹腔镜下子宫切除3种术式的比较

目的 探讨腹腔镜子宫切除3种术式的手术效果、手术适应证及并发症的预防。方法 对该院2001年8月-2006年5月有子宫切除手术指征的763例患者行腹腔镜子宫切除术，其中腹腔镜下子宫次全切除术（LSH）251例，腹腔镜筋膜内子宫切除术（CISH）245例，腹腔镜辅助阴式子宫切除术（LAVH）267例，观察手术时间、出血量、住院时间及并发症发生情况。结果 763例中，中转开腹8例，手术成功率95．37％。LSH组的手术时间、出血量及住院时间与CISH组和LAVH组比较差异均有显著性（P〈0．05），而CISH组与LAVH组比较差异无显著性（P〉0.05）。发生并发症3例，LAVH组中损伤2例，其中1例膀胱损伤，1例直肠损伤；CISH组中1例为宫颈管内积血；LSH组无并发症发生。结论 腹腔镜手术虽然具有创伤小、恢复快等优点，但严格掌握手术适应证，提高操作技术是减少并发症的关键。

Comparison of three surgical methods on laparoscopic hysterectomy

Objective To investigate therapeutic efficacy,surgical operation adaption and prevention of complications of three surgical methods for laparoscopic hysterectomy. Methobs We performed laparoscopic hysterectomy in 763 patients with the indications of surgical operation of hysterectomy from August 2001 to May 2006,of whom 251 were laparoscopic subtotal hysterectomy,245 were laparoscopic intrafascial hysterectomy,267 were laparoscope-assisted vaginal hysterectomy. Observe operative time,hemorrhage,postoperative length of stay and circumstance of complications. Results In 763 patients,8 were converted abdominal hysterectomy,the successful rate is 95.37%. There was significant difference between LSH group and other two groups (P <0.05),by comparison operative time,hemorrhage,postoperative length of stay. But there was not significant difference between CISH group and LAVH group (P >0.05). 3 had complications. 2 had been induried in LAVH group,1 bladder injury,1 rectum injury. 1 was cervix accumulating blood in CISH group. There was no complication. Conclusions Although the advantages of laparoscopic hysterectomy are of smaller wound and recovery fast,but the key to reduce complications is controlling the indications of surgical operation strictly and raising operation technique.