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首页> 外文期刊>Surgical Endoscopy >A comparison of laparoscopic supracervical hysterectomy vs laparoscopically assisted vaginal hysterectomy.
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A comparison of laparoscopic supracervical hysterectomy vs laparoscopically assisted vaginal hysterectomy.

机译：腹腔镜子宫上子宫切除术与腹腔镜辅助阴道子宫切除术的比较。

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BACKGROUND: We set out to compare the length of stay, costs, and morbidity associated with laparoscopic supracervical hysterectomy (LSH) with laparoscopically assisted vaginal hysterectomy (LAVH). METHODS: We performed a cohort analysis of consecutive patients at a university-based medical center from April 1997 through October 1999. RESULTS: A total of 145 patients were identified initially; however, 13 cases were excluded because of concomitant procedures (retropubic urethropexy, lymphadenectomy, paravaginal repair). Of the 132 patients included in the study, 27 underwent LSH and 105 underwent LAVH. The two groups were similar with respect to gravidity, parity, uterine weight, and preoperative diagnosis. Patients undergoing LSH had significantly shorter operating times (median, 181 vs 220 min, p = 0.007), briefer hospital stays (median, 1.0 vs 2.0 days, p = 0.0001), and less blood loss (median, 125 vs 400 ml, p = 0.0001). None of the patients submitted to LSH experienced morbidity, as compared with a 13% morbidity rate for LAVH (bladder injury, n = 3; blood loss >1000 ml, n = 7; vaginal cuff hematoma, n = 4; 0% vs 13%; p = 0.04). CONCLUSIONS: Patients undergoing laparoscopic supracervical hysterectomy had shorter operating times, shorter hospital stays, and less morbidity than those who underwent laparoscopically assisted vaginal hysterectomy. The practice of routine cervicectomy at laparoscopic hysterectomy should be reconsidered.
机译：背景：我们着手比较与腹腔镜辅助阴道子宫切除术（LAVH）相关的腹腔镜子宫上子宫切除术（LSH）的住院时间，费用和发病率。方法：从1997年4月至1999年10月，我们在一家大学医学中心对连续患者进行了队列分析。然而，有13例因手术（耻骨后尿道切开术，淋巴结清扫术，阴道旁修复术）而被排除在外。在这项研究的132例患者中，有27例接受了LSH，105例接受了LAVH。两组在妊娠率，胎次，子宫重量和术前诊断方面相似。接受LSH的患者手术时间明显缩短（中位181 vs 220分钟，p = 0.007），住院时间更短（中位1.0 vs 2.0天，p = 0.0001），出血量更少（中位125 vs 400 ml，p = 0.0001）。接受LSH的患者均未发生任何疾病，而LAVH的发病率为13％（膀胱损伤，n = 3;失血量> 1000 ml，n = 7;阴道套囊血肿，n = 4; 0％对13 ％; p = 0.04）。结论：与接受腹腔镜辅助阴道子宫切除术的患者相比，接受腹腔镜子宫上子宫切除术的患者具有更短的手术时间，更短的住院时间和更低的发病率。应考虑在腹腔镜子宫切除术中常规行宫颈切除术。

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