腹腔镜全子宫切除术与腹腔镜辅助阴式全子宫切除术治疗子宫肌瘤的疗效比较

目的探讨腹腔镜全子宫切除术(TLH)与腹腔镜辅助阴式全子宫切除术(LAVH)治疗子宫肌瘤的效果。方法将92例子宫肌瘤患者随机分为腹腔镜辅助阴式全子宫切除术(LAVH组)和腹腔镜全子宫切除术(TLH组)各46例,比较两组手术时间(含阴道娩出子宫的时间)、术中出血量、术后肛门排气时间、住院时间等指标;术后3个月观察两组阴道残壁愈合情况及盆腔情况。结果 92例患者手术均成功。LAVH组手术时间和术中出血量多于TLH组,两组比较,差异有统计学意义(P均0.05);两组肛门排气时间及住院治疗时间比较,差异无统计学意义(P均0.05)。术后3个月随访,两组患者阴道残端均愈合较好,盆腔检测结果未见异常,未见并发症的发生。结论对于需行子宫全切除术的患者,腹腔镜全子宫切除术与腹腔镜辅助阴式全子宫切除术相比,手术疗效更好,术程时间短,并发症少,更利于操作。

Comparison of laparoscopic hysterectomy with laparoscopic-assisted vaginal hysterectomy for uterine leiomyoma

Objective To evaluate the efficacy of total laparoscopic hysterectomy（ TLH） and laparoscopic-assisted vaginal hysterectomy（ LAVH） for uterine leiomyoma. Methods 92 patients with uterine leiomyoma were randomly divided into the TLH group and the LAVH group. Results All oparations were successful. The operation time and blood loss of the LAVH group were significantly more than those of the TLH group（ P 〈 0. 05）. While there were no significant differences between two groups in the postoperative exhaust time and hospitalization time. The vaginal stump healed well and the pelvic test results were normal 3 months after operation. No complication occurered. Conclusion Compared with laparoscopicassisted vaginal hysterectomy,total laparoscopic hysterectomy for uterine leiomyoma has the advantages of better effect,shorter operation time,less complications and being easier to operate.