腹腔镜辅助阴式全子宫切除术112报告

目的:探讨腹腔镜辅助阴式全子宫切除术(laparoscopiclly assisted vaginal hysterectomy,LAVH)的临床疗效及安全性。方法:回顾分析为112例有子宫切除指征的患者行LAVH的临床资料,术后应用抗生素规范治疗。观察术中、术后患者一般情况、手术时间、出血量、住院时间、并发症及术后随访等。结果:112例均顺利完成手术,无一例中转开腹,术后患者临床症状完全消失。6例术后阴道残端出血,经再缝扎宫颈残端后治愈;无一例发生术后腹壁切口感染、泌尿系感染、膀胱及直肠破裂、尿路刺激症状、尿潴留、术后阴道膀胱瘘等并发症。远期随访效果均满意。结论:LAVH治疗妇科良性疾病临床疗效显著,安全性高,是目前较理想的治疗方法,值得推广应用。

The clinical analysis of 112 cases of laparoscopically assisted vaginal hysterectomy

Objective：To explore the clinical efficacy and safety of laparoscopically assisted vaginal hysterectomy. Methods： Laparoscopically assisted vaginal hysterectomy was carried out in 112 patients who were analyzed retrospectively with hysteromyoma, uterine adenomyoma, ovarian tumor, cervical intraepithelial neoplasia grade Ⅲ, or atypical hyperplasia of endometrium, which were all indications for uterus resection and treated with antibiotic standard treatment. The intraoperative and postoperative general condition of patients, surgical time, blood loss, hospital stay, complications and postoperative follow-up were observed. Results： All operations were successful, no one convert to laparotomy and clinical symptoms disappeared post operation. Postoperative vaginal bleeding occurred in 6 cases and disappeared after suture cervical residual sheath cure. Other complications including postoperative abdominal wall Wound infec- tion, urinary tract infection, rupture of the bladder and rectum, urinary irritation symptoms, urinary retention and postoperative vaginal bladder fistula complications were not occurred. The long-term follow-up were satisfying. Conclusions ： Using laparoscopieally assisted vaginal hysterectomy to treat benign gynecological diseases, has good clinical effect, and is safe and ideal treatment worthying of widespread clinical application.