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目的探讨改良式腹腔镜下大子宫次全切除术的手术技巧、可行性和安全性。方法将2012年7月至2013年7月68例子宫超过12孕周大小,分别行改良式腹腔镜子宫次全切除术(改良LSH组)38例及常规腹腔镜子宫次全切除术(常规LSH组)30例。比较两组患者的手术时间、术中出血量、并发症发生率、术后肛门恢复排气时间等。结果所有患者均在腹腔镜下完成,无1例中转开腹。两组肛门恢复排气时间、术后住院时间、术后并发症发生率差异均无统计学意义(P均>0.05)。改良组、常规组手术时间分别为(90.6±18.2)min、(112.9±24.5)min,差异有统计学意义(P<0.05);术中出血量分别为(49.8±26.9)ml、(73.8±50.8)ml,两组差异有统计学意义(P<0.05)。结论改良式腹腔镜下大子宫次全切除术安全、可行,宫旁血管的预先处理更符合微创的要求。
Objective To investigate the surgical technique, feasibility and safety of modified laparoscopic radical hysterectomy. Methods A total of 68 cases of uterus from July 2012 to July 2013 were enrolled in this study. They were treated with modified laparoscopic subtotal hysterectomy (modified LSH group) 38 cases and conventional laparoscopic hysterectomy (conventional LSH Group) 30 cases. The operation time, intraoperative blood loss, the incidence of complications, postoperative anus recovery exhaust time and so on were compared between the two groups. Results All patients underwent laparoscopic surgery. None of the patients underwent laparotomy. There was no significant difference in anal exhaust time, postoperative hospital stay and incidence of postoperative complications between the two groups (all P> 0.05). The operation time of the modified group and conventional group were (90.6 ± 18.2) min and (112.9 ± 24.5) min, respectively, and the difference was statistically significant (P <0.05); the blood loss was (49.8 ± 26.9) ml and 50.8) ml, the difference between the two groups was statistically significant (P <0.05). Conclusion The modified laparoscopic radical hysterectomy is safe and feasible. The pre-treatment of uterine blood vessels is more in line with the requirements of minimally invasive surgery.