经阴道与阴道辅助的腹腔镜全子宫切除术的效果比较

目的:比较全子宫切除两种微创术式临床效果。方法:回顾分析皖南医学院附属弋矶山医院2007年2月～2009年12月非脱垂子宫的经阴道子宫切除术(TVH)80例和阴道辅助的腹腔镜子宫切除术(VALH)38例的临床资料,分析一般资料及围手术期资料特点。结果:两组在年龄、BMI、子宫大小、手术指征、合并附件病变等一般资料上无明显差异。与TVH组相比,VALH组的手术时间长,出血量多,费用高,差异有统计学意义(P<0.05)。VALH组的术后病率高于TVH组,但两组间差异无统计学意义。结论:阴式手术相对腹腔镜手术更易掌握和实施,且费用低。在术前进行充分评估,排除阴式手术禁忌症,TVH应是最好的术式选择。

Clinical outcomes of transvaginal hysterectomy versus vaginally-assisted laparoscopic hysterectomy

Objective：To compare the clinical outcomes of two minimally invasive procedures /hysterectomy. Methods：The clinical data together with general information and perioperative data were reviewed in 80 patients received transvaginal hysterectomy（TVH） and 38 undergone vaginally-assisted laparoscopic hysterectomy（VALH） for treatment of non-prolapsed uterus in the affiliated Yijishan Hospital of Wannan Medical University between Feb. 2007 and Dec. 2009.Results：No statistical difference was found between the two groups concerning ages,body mass index,size of the uterus operative indications and associated pathological change of the adnexa uteri.VALH consumed longer operation time,with more intraoperative bleeding and much medical charge as compared with TVH（P0.05）. The postoperative morbidity in VALH group was higher than that of TVH,but that suggested no significant statistical difference.Conclusion：Vaginal surgery is easy to manage and low in medical cost compared with laparoscopic approach. Given careful preoperative assessment and consideration of the contradictions,TVH should be the first choice of hysterectomy.