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首页> 外文期刊>Journal of minimally invasive gynecology >Laparoscopic-assisted vaginal hysterectomy versus minilaparotomy hysterectomy: a prospective, randomized, multicenter study.
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Laparoscopic-assisted vaginal hysterectomy versus minilaparotomy hysterectomy: a prospective, randomized, multicenter study.

机译：腹腔镜辅助阴道子宫切除术与小型腹腔镜子宫切除术：一项前瞻性，随机，多中心研究。

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STUDY OBJECTIVE: The aim of this study was to compare operative and early postoperative outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH) and minilaparotomy in a randomized clinical trial including patients undergoing total hysterectomy for benign gynecologic disease and having 1 or more of the generally considered contraindications to vaginal route. DESIGN: Prospective, randomized, multicenter trial (Canadian Task Force classification I). SETTING: Departments of Gynecology from 3 major university hospitals in Rome. PATIENTS: Eighty-one patients who were candidates for abdominal hysterectomy. INTERVENTIONS: Laparoscopic-assisted vaginal hysterectomy and minilaparotomy hysterectomy. MEASUREMENTS AND MAIN RESULTS: Forty patients were randomized to LAVH and 41 to minilaparotomy. Characteristics of patients and indications for surgery in the 2 arms were comparable. In the minilaparotomy group, complications were as follows: 1 case (2.4%) of delayed laparotomy with 2 units of red blood cell transfusion, 2 cases (4.8%) of wound infection, and 3 cases (7.3%) of fever of unknown origin. No minor or major complications were observed in the LAVH group. Postoperative visual analog scale pain scores at days 1 and 2 were significantly lower in the LAVH group (p <.05). The complication rate between the 2 groups was significantly lower for LAVH (p = .026). CONCLUSION: Because LAVH was associated with significantly lower early postoperative pain scores and complication rates, in general LAVH should be preferred to minilaparotomy hysterectomy when the vaginal approach cannot be used.
机译：研究目的：这项研究的目的是在一项随机临床试验中比较腹腔镜辅助阴道子宫切除术（LAVH）和小型腹腔镜切除术的手术和术后结局，其中包括因良性妇科疾病而接受全子宫切除术并具有一项或多项公认的患者禁忌阴道途径。设计：前瞻性，随机，多中心试验（加拿大工作组I级）。地点：罗马3家主要大学医院的妇科。患者：81例患者接受了子宫全子宫切除术。干预：腹腔镜辅助阴道子宫切除术和小型腹腔镜子宫切除术。测量和主要结果：40例患者被随机分为LAVH组和41例行小切口开腹手术。两组患者的特征和手术适应症相当。小型剖腹手术组并发症如下：1例（2.4％）延迟剖腹手术，输注2单位红细胞，2例（4.8％）伤口感染，3例（7.3％）发源不明的发热。 LAVH组未观察到轻度或重度并发症。 LAVH组第1天和第2天的术后视觉模拟评分疼痛评分显着降低（p <.05）。对于LAVH，两组之间的并发症发生率明显更低（p = .026）。结论：由于LAVH与术后早期疼痛评分和并发症发生率显着降低有关，因此一般来说，当不能采用阴道入路时，LAVH应首选微型腹腔镜子宫切除术。

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