改良腹腔镜辅助阴式较大子宫切除术125例临床分析

目的:对比分析传统经腹子宫切除术(transabdominal hysterectomy,TAH)与改良腹腔镜辅助阴式子宫切除术(modified laparoscopic-assisted transvaginal hysterectomy,MLAVH)治疗子宫腺肌病及大子宫肌瘤(子宫≥如孕16周)的临床效果。方法:回顾分析2008年4月至2012年6月为248例较大子宫肌瘤或子宫腺肌病患者行子宫切除术的临床资料,其中125例行MLAVH(研究组),123例行传统TAH(对照组),对比两组手术时间、术中出血量、术后疼痛及肛门排气时间。结果:248例手术均顺利完成,两组患者手术时间差异无统计学意义(P>0.05),研究组术中出血量明显减少、肛门排气时间缩短、术后疼痛轻(P<0.05)。术后近期随访,均无严重并发症发生。结论:MLAVH可降低较大子宫切除术的手术难度,减少术中出血。

Modified laparoscopic-assisted transvaginal hysterectomy for larger uterus:with a clinical analysis of 125 cases

Objective:To compare the clinical effect of traditional transabdominal hysterectomy(TAH) and modified laparoscopic-assisted transvaginal hysterectomy(MLAVH) in treatment of adenomyosis or large uterine fibroids(uterine≥16 gestational weeks).Methods:The clinical data of 248 patients who suffered from uterine fibroids or adenomyosis with larger uterus and underwent hysterectomy from Apr.2008 to Jun.2012 were retrospectively analyzed.MLAVH was performed in 125 patients(the study group) and TAH was performed in 123 cases(the control group).The operative time,intra-operative blood loss,postoperative pain and anus exhausting time were comparatively analyzed.Results:All the 248 operations were successfully accomplished.The operative time was not significantly different between the two groups(P>0.05),while the intra-operative blood loss,postoperative pain and anus exhausting time were significantly decreased in the study group compared to the control group(P<0.05).No serious complications occurred during the short-term follow-up.Conclusions:MLAVH can reduce the difficulty and blood loss of hysterectomy for larger uterus.