应用杯状举宫器及血管闭合器行完全腹腔镜全子宫切除术的临床观察

目的：探讨应用杯状举宫器及血管闭合器行腹腔镜全子宫切除术（TLH）的临床意义。方法：回顾性分析本院2005年3月～2009年9月应用杯状举宫器及血管闭合器（ligasure）行完全腹腔镜全子宫切除术38例（TLH组）与同期开腹全子宫切除术35例（TAH组）患者的临床资料,比较两组手术时间、术中出血、术后恢复等情况。结果：TAH组手术时间（153.0±31.9）min,术中出血（122.6±33.1）ml,TLH组手术时间（93.6±13.0）min,术中出血（59.5±19.5）ml,TLH组比TAH组手术时间短、术中出血少、术后肛门排气快、术后病率低、并发症少、住院时间短,差异有统计学意义,P〈0.05。结论：用杯状举宫器及双极血管闭合器行完全腹腔镜全子宫切除术,不但美观、微创,而且手术效果好、出血少、恢复快,值得推广。

Clinical observation of total laparoscopic hysterectomy assisted with electrosurgical bipolar vessel sealing and cup-like utero-vaginal elevator

Objective：To evaluate the clinical importance for the usage of electrosurgical bipolar vessel sealing（EBVE） and cup-like utero-vaginal elevator（CLUVE） in total laparoscopic hysterectomy.Methods：Review with analysis on the clinical data of the cases who were received total laparoscopic hysterectomy assisted with EBVE and CLUVE from March 2005 to September 2009 in our hospital.Compared the operation time,intraoperative blood,as well as postoperative recovery time between 35 cases with transabdominal hysterectomy（TAH） and 38 cases with total laparoscopic hysterectomy（TLH）.Results：The operation time and intraoperative blood in TAH group were（153.0±31.9） min and（122.6±33.1） ml,respectively,while that in TLH group were（93.6±13.0） min and（59.5±19.5） ml,respectively.The advantage of low intraoperative blood,short operation-time,short recovery time,fast postoperative exhaust via anus,and low postoperative pyrexia rate etc.were observed in TLH group compared with that in TAH group,and the results showed that there exist significant difference between these two groups（P〈0.05）.Conclusion：The utilization of electrosurgical bipolar vessel sealing and cup-like uterovaginal elevator in total laparoscopic hysterectomy may bring not only small surgical cut but also high operation quality,thus be worth of expansion usage.