https://scholars.lib.ntu.edu.tw/handle/123456789/546089
標題: | Successful laparoscopically assisted vaginal hysterectomies for large uteri of various sizes | 作者: | WEN-CHUN CHANG Huang S.-C. BOR-CHING SHEU PAO-LING TORNG Hsu W.-C. Chen S.-Y. DAW-YUAN CHANG |
公開日期: | 2008 | 卷: | 87 | 期: | 5 | 起(迄)頁: | 558-563 | 來源出版物: | Acta Obstetricia et Gynecologica Scandinavica | 摘要: | Background. To study if there are specific problems in laparoscopically assisted vaginal hysterectomy (LAVH) for a certain weight of bulky uteri and the strategies to overcome such problems. Methods. One hundred and eighty-one women with myoma or adenomyosis, weighing 350-1,590 g, underwent LAVH between August 2002 and December 2005. Key surgical strategies were special sites for trocar insertion, uterine artery or adnexal collateral pre-ligation, laparoscopic and transvaginal volume reduction technique. The basic clinical and operative parameters were recorded for analysis. Results. Based on significant differences in the operative time and estimated blood loss, the patients were divided into medium uteri weighing 350-749 g, n=138 (76%), and large uteri weighing ?750 g, n=43 (24%). There was no significant difference in terms of age, body mass index, preoperative diagnoses, complications and duration of hospital stay among groups. The operative time and estimated blood loss increased with larger uterine size (p<0.001). The operative time (196±53, 115-395 min), estimated blood loss (234±200, 50-1,000 ml) and frequency of excessive bleeding (14%) or transfusion (5%) were significantly greater, but in acceptable ranges, for those with large uteri. Conversion to laparotomy was required in a patient (2%) with a large uterus, and the overall conversion rate was 0.6%. There was no re-operation or surgical mortality. Conclusion. Using various combinations of special strategies, most experienced gynecologic surgeons can conduct LAVH for most large uteri with minimal rates of complications and conversion to laparotomy. ? 2008 Taylor & Francis. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-43049151767&doi=10.1080%2f00016340802011587&partnerID=40&md5=a4b779d0fe20db78100195072224c4dd https://scholars.lib.ntu.edu.tw/handle/123456789/546089 |
ISSN: | 0001-6349 | DOI: | 10.1080/00016340802011587 | SDG/關鍵字: | adenomyosis; adult; article; bleeding; blood transfusion; body mass; female; hospitalization; human; laparoscopic surgery; laparotomy; length of stay; major clinical study; myoma; operation duration; priority journal; reoperation; surgical mortality; time series analysis; treatment outcome; uterine artery; uterus malformation; uterus weight; vaginal hysterectomy; bleeding; histology; laparoscopy; methodology; organ size; uterus; uterus disease; vaginal hysterectomy; Blood Loss, Surgical; Female; Humans; Hysterectomy, Vaginal; Laparoscopy; Length of Stay; Organ Size; Uterine Diseases; Uterus |
顯示於: | 醫學系 |
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