腹腔镜辅助阴式切除盆腔后部深部浸润型 子宫内膜异位症全子宫的方法改良

Improvement of laparoscopic assisted vaginal hysterectomy for deep infiltrating endometriosis in posterior pelvic cavity

摘要:

目的 探讨采用改良后腹腔镜辅助阴式子宫切除术切除严重子宫内膜异位症全子宫的疗效。方法 选择同期由同一手术医师进行的常规腹腔镜辅助阴式子宫切除术与改良后腹腔镜辅助下阴式子宫切除术的病例98例，其中，常规腹腔镜辅助阴式子宫切除术46例，改良后腹腔镜辅助下阴式子宫切除术52例，比较两组的手术时间、术中出血量、手术并发症、肛门排气时间、术后病率及术后住院天数。结果 常规组手术时间（122.4±28.6）min，改良组为（102.2±38.4）min，两组比较差异有显著性，P <0.05；常规组术中出血量为（234.4±102.6）mL，改良组为（222.4±111.8）mL，两组比较差异无显著性，P >0.05。常规组中转开腹3例，改良组无1例中转开腹，两组均无手术并发症。结论 采用改良后的方法，提高了严重子宫内膜异位症患者腹腔镜下经阴道子宫切除手术的安全性及成功率，扩大了腹腔镜的手术指征。

Abstract:

【Objective】 To explore the curative effect of improved laparoscopic assisted vaginal hysterectomy in treating deep infiltrating endometriosis of posterior pelvic cavity. 【Methods】 46 routine laparoscopic assisted vaginal hysterectomies and 52 improved laparoscopic assisted vaginal hysterectomies were accomplished by the same operation doctor. The operation time, blood volume, operation complication, time of anus passage gas, post- operation disease incidence and post- operation hospital days of two operations were compared. 【Results】 There were statistics discrepancy (P <0.05) about operation time of two groups (routine laparoscopic assisted vaginal hysterectomy: (122.4±28.6) min, improved laparoscopic assisted vaginal hysterectomy (102.2±38.4)min, There were no statistics discrepancy (P >0.05) about blood volume of two groups routine laparoscopic assisted vaginal hysterectomy (234.4±102.6)mL; Improved laparoscopic assisted vaginal hysterectomy (222.4±111.8)mL. 3 routine laparoscopic assisted vaginal hysterectomies were changed to opening abdomen operation; but there was no one operation changed to opening abdomen operation. There were no operation complications in two groups. 【Conclusion】 Improved laparoscopic assisted vaginal hysterectomy can boost operation safe and achievement ratio of hysterectomy about severe endometriosis, expand laparoscopic operation indication.