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目的:探讨困难的腹腔镜下全子宫切除术(laparoscopic total hysterectomy,LTH)的手术技巧和安全性。方法:回顾分析100例广东武警总队医院及重庆第三军医大学西南医院各种困难情况下行LTH的患者的临床资料,并在手术时间、出血量及术后恢复等各方面与同期随机选择的130例子宫<孕12周及各种较简易情况下行LTH的患者临床资料进行比较。结果:研究组100例均在腹腔镜下顺利完成手术,无1例严重并发症发生。研究组手术时间为(90.2±25.6)min,与对照组[(60.0±10.5)min]比较差异有统计学意义(P<0.05)。两组出血量分别为(80.1±25.9)ml和(70.2±20.1)ml,差异无统计学意义(P>0.05)。术后恢复各指标与对照组比较差异无统计学意义(P>0.05)。结论:在各种困难情况下行LTH在熟悉宫旁解剖、熟练掌握的腹腔镜手术器械及技巧的情况下是安全可行的,不会增加其危险性和并发症。
Objective: To investigate the surgical technique and safety of difficult laparoscopic total hysterectomy (LTH). Methods: The clinical data of 100 patients with LTH under various difficulties in Guangdong Armed Police Corps Hospital and Southwest Hospital of Third Military Medical University in Chongqing were retrospectively analyzed. The clinical data of 130 patients randomly selected at the same period in terms of operation time, blood loss and postoperative recovery were analyzed. Cases of 0.05). There was no significant difference between the indexes of postoperative recovery and the control group (P> 0.05). CONCLUSIONS: LTH is safe and feasible in all kinds of difficult situations with familiar paracrine dissection, well-established laparoscopic instruments and techniques without increasing its risk and complications.