腹腔镜下大子宫切除术75例临床分析

目的 探讨腹腔镜下大子宫切除术的安全性及手术技巧.方法 回顾性分析2007年1月～2009年6月75例子宫超过12孕周行腹腔镜子宫切除手术的临床资料,其中41例腹腔镜下全子宫切除术,34例腹腔镜子宫次全切除术.结果 75例全部在腹腔镜下完成手术,无一例中转开腹,无一例手术并发症发生.手术时间（86.9±21.5） min,术中出血量（118.4±31.8） ml,术后住院时间（5.3±0.7） d.75例随访6个月,无一例出现术后并发症.结论 选择合适的置镜孔,处理好附件及子宫血管,腹腔镜下大子宫切除术安全、可行,不会增加手术危险性和手术并发症,但要求术者具备丰富的腹腔镜手术经验.

Clinical analysis of hysterectomy of large uterus for 75 cases under laparoscopy

Objective To investigate the operative safety and skills of laparoscopic hysterectomy of large uterus. Methods A retrospective analysis was conducted on clinical data from 75 cases whose uterus were bigger than twelve gestational age uterus and therefore treated with laparoscopic hysterectomy from January 2007 to June 2009. Among the 75 cases ,41 received total laparoscopic hysterectomy（TLH） ,34 received laparoscopic supracervical hysterectomy（LSH）. Results All operations （75 cases）were performed successfully under laparoscopy. No operating complication happened in any cases. The operating time was （86.9 ± 21.5 ）min, hlood loss in operation was （128 ± 30 ）ml. The average postoperative hospital stay was （ 5.3 ± 0.7 ） days. No postoperative complication was found in all cases during the 6 - month follow - up. Conclusions Laparoscopie hysterectomy of large uterus is safe and feasible, and does not increase operative risk and incidence of complications, when suitable laparoscopic location is selected and treatments of adnexa and uterine vessel are well performed. The operator having rich laparoscopie operative experience is the most important.