摘要
目的探讨腹腔镜下不同术式子宫切除术适应证及临床应用价值. 方法回顾分析2003年1月～2004年3月151例不同术式腹腔镜子宫切除术.其中腹腔镜筋膜内子宫切除术(classic interfascial supracervical hysterectomy, CISH)19例,腹腔镜辅助下阴式子宫切除术(laparoscopic assisted vaginal hysterectomy, LAVH)60例,腹腔镜次全子宫切除术(laparoscopic supracervical hysterectomy, LSH)67例,腹腔镜下全子宫切除术(laparoscopic total hysterecotomy, LTH)5例,对40例＞孕12周子宫的手术方法进行改进. 结果无一例中转开腹,无并发症发生.各术式手术时间、术中出血、术后排气及住院时间为CISH(109.2±14.4) min,(80.5±14.3) ml, (21.1±3.2) h, (4.2±0.4) d;LAVH(108.7±14.8) min, (79.8±10.0) ml,(20.6±2.7) h,(4.2±0.4) d;LSH(107.6±24.2) min, (80.8±17.2) ml, (20.4±2.0) h,(4.1±0.5) d;LTH(110.0±12.3) min, (80.0±18.7) ml, (20.8±1.9) h, (4.2±0.5) d.40例较大子宫技术性改进手术方法均获成功. 结论腹腔镜下各种子宫切除术各有其适应证及优缺点,应根据病人的具体情况选择具体的手术方式.
Objective To discuss indications and clinical values of different types of laparoscopic hysterectomy. Methods A retrospective analysis of 151 cases of different types of laparoscopic hysterectomy from January 2003 to February 2004 was made. The patients consisted of 19 cases of classical intrafascial supracervical hysterectomy （CISH） , 60 cases of laparoscopically assisted vaginal hysterectomy （ LAVH）, 67 cases of laparoscopic supracervical hysterectomy （ LSH ） , 5 patients of laparoscopic total hysterectomy （LTH）. The surgical techniques were modified in 40 patients with uterus increased in size as 〉 12 weeks of gestation. Results No conversions to open surgery were needed, and no complications were observed. The operation time, intraoperative hemorrhage volume,time to first passing flatus, and length of hospitalization were respectively 109.2 ±14.4 min, 80.5 ＋ 14.3 ml, 21. 1 ＋ 3.2 h, and 4.2 ±0.4 d for CISH, 108.7 ± 14.8 min, 79.8 ± 10.0 ml, 20.6 ±2.7 h, and 4.2 ±0.4 d for LAVH, 107.6 ± 24.2 min, 80.8 ±17.2 ml, 20.4 ±2.0 h, and4.1 ±0.5 d for LSH, and 110.0 ± 12.3 min, 80.0 ± 18.7 ml, 20.8 ± 1.9 h, and 4.2 ±0.5 d for LTH.The modified surgical procedures were successfully accomplished in all the 40 patients with extended uterus. Conclusions Different types of laparoscopic hysterectomy present different indications, advantages and disadvantages. The treatment should be individualized.
出处
《中国微创外科杂志》
CSCD
2005年第8期655-656,共2页
Chinese Journal of Minimally Invasive Surgery
