腹腔镜辅助阴式子宫切除术32例

目的通过对比分析腹腔镜辅助阴式子宫切除术（LAVH）与经阴道全子宫切除术（TVH）的不同手术适应症及效果,探讨LAVH与TVH手术的利弊。方法回顾性分析南华医院妇产科LAVH与TVH手术72例,分析两种手术方式在手术时间、术中出血量、术后住院时间、术中术后的并发症以及两者的手术适应症的不同。结果两组在手术时间、术中出血量、术后疼痛、肛门排气时间、术后住院时间、术后输液等方面差异无显著性。LAVH中转开腹与患者盆腔粘连情况及手术难度情况有关,而TVH组患者多为正常或小于正常大小的子宫,无盆腔粘连,不伴有附件病变者,手术适应症明显受限。结论TVH与LAVH均为创伤小、恢复快的微创手术,但TVH适合于子宫小、无手术史、无粘连并且伴脱垂者,LAVH扩大了TVH适应症,在临床上具有更大的发展空间。

Clinical Analysis of 30 Cases With Laparoscopic-assisted Vaginal Hysterectomy

Objective By comparing the different surgical indications and results of laparoseopic - assisted vaginal hysterectomy （LAVH） and vaginal hysterectomy （TVH） , to explore their pros and cons for patients. Methods 72 eases of LAVH or TVH surgery in obstetrics and gynecology department of Nanhua hospital were retrospectively analyzed, and their surgical time, bleeding volume, hospital day after surgery, complications after surgery and surgical indications were compared. Results The difference of the two groups of surgery in operative time, bleeding volume, postoperative pain, anal exhaust time, postoperative length of stay, postoperative transfusion and so on was not significant. LAVH conversion was related to pelvic adhesions in patients and difficult level of surgery, while patients of TVH had normal or less than normal - sized uterus and no pelvic adhesions, attachment without lesions, which were obviously restricted. Conclusion TVH and LAVH are minimally invasive surgery with small trauma and quick recovery, but TVH fit in the small uterus, without surgery history and adhesion and those with prolapse, and LAVH had greater clinical development space.