悬吊式腹腔镜辅助阴式子宫切除术50例临床分析

Gasless laparoscopic assisted hysterectomy for moderate enlarged uterus:Report of 50 cases

关键词:  悬吊式腹腔镜辅助阴式子宫切除术  子宫肌瘤  子宫腺肌病

Key words:  gasless laparoscopic assisted hysterectomy  hysteromyoma  adenomyosis

摘要:

［目的］ 探讨悬吊式腹腔镜辅助阴式大子宫切除术的安全性和可行性。［方法］ 对2005年7月~2009年7月50例子宫增大如12～20孕周子宫肌瘤、子宫肌腺症患者，行悬吊式腹腔镜辅助阴式子宫切除术（GLH组）。随机选取50例条件相同患者进行传统开腹全子宫切除手术（TAH组），对两组手术时间、出血量、术后住院时间及术后镇痛情况进行分析。［结果］ 两组手术过程顺利，无中转开腹。与TAH组相比，GLH组术后住院时间短、术后镇痛者少（P<0.05），但手术时间长（P<0.05）、术中出血量差异无显著性意义。［结论］ 对部分因良性病变≥12孕周子宫，术者具有熟练腹腔镜、阴式手术操作经验，悬吊式腹腔镜辅助阴式子宫切除术是安全可行的。

Abstract:

［Objective］ To investigate the safety and feasibility of gasless laparoscopic assisted hysterectomy (GLH) for moderate enlarged uterus compared to total abdominal hysterectomy. ［Methods］ A comparative study of GLH using an abdominal wall-lifting device (n=50) and total abdominal hysterectomy (TAH, n=50) was carried out from July 2005 to July 2009. The uterine size was equivalent to 12～20 gestational weeks. The operation time, blood loss, postoperative stay, and postoperative meperidine use were observed and analyzed. ［Results］ The operative time was (168±38) min and (112±29) min (P<0.05) for the GLH and TAH groups, respectively. Gasless laparoscopic hysterectomy cases had a shorter hospital stay ［(5.5±1.2) days vs (7.3±1.2) days, P<0.05 respectively］. Postoperative meperidine use was lower in GLH (P<0.05). Estimated blood loss was equal to GLH (P=0.216). ［Conclusions］ Gasless laparoscopic assisted hysterectomy is safe and feasible for moderate enlarged uterus (≥12 gestational weeks) in experienced hands.