https://scholars.lib.ntu.edu.tw/handle/123456789/546088
標題: | Laparoscopic-Assisted Vaginal Hysterectomy with In Situ Morcellation for Large Uteri | 作者: | Chen S.-Y. DAW-YUAN CHANG BOR-CHING SHEU PAO-LING TORNG Huang S.-C. Hsu W.-C. WEN-CHUN CHANG |
公開日期: | 2008 | 卷: | 15 | 期: | 5 | 起(迄)頁: | 559-565 | 來源出版物: | Journal of Minimally Invasive Gynecology | 摘要: | Study Objective: To estimate whether laparoscopic in situ morcellation (LISM) can facilitate laparoscopic-assisted vaginal hysterectomy (LAVH) for large uteri. Design: Prospective study (Canadian Task Force classification II-1). Setting: University-affiliated hospital. Patients: In all, 147 women with myoma or adenomyosis weighing more than 500 g from January 2004 through December 2007 were enrolled. The patients were divided into 4 subgroups: patients with uteri weighing 500 to 749 g who had traditional LAVH without LISM (group 1A, n = 69) or with LISM (group 1B, n = 16); and patients with uteri weighing 750 g or more who were treated by traditional LAVH without LISM (group 2A, n = 38) or with LISM (group 2B, n = 24). Interventions: Laparoscopic-assisted vaginal hysterectomy with or without LISM. Measurement and Main Results: No significant differences existed in age, body mass index, preoperative diagnoses, complications, or duration of hospital stay among groups. The mean uterine weights were 608 ± 75, 597 ± 66, 989 ± 179, and 935 ± 226 g for groups 1A, 1B, 2A, and 2B, respectively. The operative time (120 ± 16 vs 157 ± 36 minutes, p <.001; 140 ± 19 vs 224 ± 57 minutes, p <.001) were significantly shorter in patients with LISM than without in both groups 1 and 2. The estimated blood loss was highest in group 2A. Six (16%) patients lost more than 500 mL of blood and 3 (8%) of them needed blood transfusions. Conversion to laparotomy occurred in 1 (2.6%) of 38 patients in group 2A. No repeated surgery or surgical mortality occurred. Conclusion: Laparoscopic-assisted vaginal hysterectomy with LISM was an efficient and safe procedure for removal of large uteri during LAVH. ? 2008 AAGL. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-49649083761&doi=10.1016%2fj.jmig.2008.06.002&partnerID=40&md5=9ff6828c897c7bcf0f54ec503641320e https://scholars.lib.ntu.edu.tw/handle/123456789/546088 |
ISSN: | 1553-4650 | DOI: | 10.1016/j.jmig.2008.06.002 | SDG/關鍵字: | adenomyosis; adult; article; bleeding; blood transfusion; body mass; body weight; female; human; laparoscopic surgery; laparotomy; length of stay; major clinical study; morcellation; myoma; operation duration; prospective study; uterus surgery; uterus weight; vaginal hysterectomy; Adenomyoma; Adult; Blood Loss, Surgical; Case-Control Studies; Female; Humans; Hysterectomy, Vaginal; Laparoscopy; Leiomyomatosis; Middle Aged; Organ Size; Uterine Neoplasms; Uterus |
顯示於: | 醫學系 |
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