| Purpose :Obstetrics and Gynecology hysterectomy surgery is more common in the surgery。With the progress of social civilization and people on health and medical understanding of the gradual maturity. Physicians have tried everything possible to reduce a variety of chemical drugs and surgery to patients with heavy bleeding and damage Light, electricity (microele- ctronics) technology development, to further broaden its application in the medical field, a variety of emerging high-tech medical equipment, bio-medicine and became, after yet another significant contribution to human health creation。Since 1987, French doctor Mouret performed the first laparoscopic cholecystectomy has gradually been applied to laparoscopic treatment of celiac disease, since with the introduction of digital video technology, laparoscopic surgical techniques become the subject of one of the fastest-growing . Palmer for the first time in 1947 will be applied to gynecological laparoscopy, also entered the era of minimally invasive gynecologic surgery, With modern technology, the continuous development of laparoscopic surgery for diagnosis and treatment for the same integration process is widely used in gynecology, especially in benign uterine tumor diagnosis and treatment of tumors and accessories play an important role in laparoscopic surgery as the representative minimally invasive gynecologic surgery and related clinical and basic research is the research hotspot in recent years, the technology of today is no longer only a few doctors know of the "mysterious" technology. Abdominal hysterectomy is the classical surgical procedures. Laparoscopic surgery, not only with traditional open surgery to achieve the same effect, but also with less trauma and faster recovery, fewer complications, the advantages of laparoscopic operating skills if the skilled laparoscopic hysterectomy is an ideal surgery.Severe adenomyosis caused by dysmenorrhea, submucosal uterine fibroids cause anemia caused by menorrhagia and multiple uterine fibroids, large uterine fibroids and uterine bleeding caused by Zheng Hou group is troubled by a series of common benign disease of women . Uterine fibroids are increasingly becoming younger and younger age of onset, with an average age of 35 to 36 years old, with the people's quality of life require the continuous improvement of gynecological diseases increasing emphasis, however, there are some patients due to serious adenomyosis, multiple large uterine fibroids or uterine fibroids, as well as the implementation of refractory dysfunctional uterine bleeding had hysterectomy. As a minimally invasive surgical method, laparoscopic hysterectomy compared with abdominal surgery there is the advantage of how embodied in this paper, retrospective analysis of the way through to further explore the laparoscopy in gynecological surgery advantages and feasibility. Methods:the collection of China-Japan union Hospital of Jilin University in January 2007 ~ July 2009 because of benign gynecological diseases were 205 cases of hysterectomy patients (including 181 cases of uterine fibroids, adenomyosis in 20 cases, dysfunctional uterine bleeding, 4 cases ), all operations through smoothly, and postoperative patients were discharged from hospital. The completion of follow-up of 163 cases in which follow-up rate of 79.5%. All the cases were divided into laparoscopic group (LH group), laparotomy group (AH group) LH group of 86 cases, AH group of 119 cases, all patients had no child-bearing requirements, the age of 40 to 55 years old, with an average 45.5 years old, two groups were age, general health status, surgical indication, uterine size, degree of pelvic adhesions was no significant difference (P> 0.05). All patients were routinely systemic examination and gynecological examination, all patients to do routine cervical cytology, vaginal bleeding irregular line of sub-curettage to rule out malignant lesions, preoperative skin preparation 1 day, rows of conventional preoperative preparation. Two groups of patients were Shi surgery, two groups of surgeons for the same level of physicians, surgical proficiency line. Postoperative vital signs and vaginal bleeding cases, antibiotics intravenously to prevent infection, did not exhaust the whole flow of water into the pre-Zhu Huanzhe given parenteral nutrition. 3 days after the first review of blood, urine routine. Postoperative follow-up for six months. Line between the two groups by the same surgical (hysterectomy or subtotal hysterectomy) patients in the operative time, blood loss, intraoperative complications (ureteral bladder and bowel injury), and postoperative pain conditions (the first get out of bed time), postoperative maximum body temperature, postoperative complications (bowel obstruction, deep vein thrombosis), incision healing, hospitalization, postoperative recovery (return to normal daily life), and postoperative follow-up, etc. comparative analysis to observe.The results:Statistical results, with total hysterectomy, the laparoscopic group operative time was 145.91±42.05min, open group, the operation time was 86.25±18.68min, laparoscopic group operative time was longer than the open group, the difference is significant (t = 7.42, P <0.05), laparoscopic group, the blood loss was 58.81±60.14ml, laparotomy group blood loss was 116.67±80.00ml, laparoscopic group, the bleeding was significantly less than the open group The difference was significant (t =- 2.87, P <0.05), after laparoscopic group and open group, the maximum temperature was 37.81±0.39℃, 37.75±0.35℃, the difference was not significant (t = 0.54 , P> 0.05), Laparoscopic group, intestinal function recovery time was 2.18±0.59d, open group of intestinal function recovery time was 2.92±0.69d, laparoscopic group, the intestinal function of time shorter than the open group, the difference was significant (t =- 4.15, P <0.05); laparoscopic group, the hospital stay was 8.58±1.77d, open group of hospital stay was 10.31±1.56d, laparoscopic group was significantly shorter hospital stay open group, the difference was significant (t =- 3.712, P <0.05); subtotal hysterectomy, laparoscopic group operative time was 108.79±32.27min, open group, the operation time was 82.80±25.49min, laparoscopic group operative time was longer than the open group, the difference is significant (t = 4.59 , P <0.05), laparoscopic group, the blood loss was 61.76±113.57ml, laparotomy group blood loss was 124.80±85.91ml, the laparoscopic group, blood loss was less than open group, the difference There was a significant (t =- 3.21, P <0.05), After laparoscopic group and open group, the maximum temperature was 37.66±0.39℃, 37.65±0.33℃, the difference was not significant (t = 0.91, P> 0.05); laparoscopic group intestinal function recovery time was 2.38±0.52d , open group of intestinal function recovery time was 2.72±0.64d, laparoscopic group, the intestinal function of time shorter than the laparotomy group, (t =- 3.04, P <0.05); laparoscopic group, the hospital stay was 8.67±1.91d , open group of hospital stay was 9.5±1.47d, laparoscopic group was significantly shorter hospital stay open group, the difference was significant difference was significant (t =- 2.498, P <0.05).In all patients and no case of serious complications, intraoperative complications of laparoscopic group was 2 / 86 (2.33%) vs intraoperative complication rate was 3.36%, the difference was significant ( P <0.05), intraoperative complications in laparoscopic group were significantly lower than the open group. Of postoperative complication rate was 3 / 86 (3.49%) vs postoperative complication rate was 5.04%, the difference was significant (P <0.05), Of postoperative complications was significantly lower than open surgery group. Postoperative follow-up.The recovery time of laparoscopic group was 15 to 20 days, significantly shorter than those in open group, 30 to 45 days, another for hysterectomy patients, the laparoscopic group occurred in patients with dysfunction of the seriousness of the ratio of 2 / 24 (8.33%) also significantly less than the open group of 6 / 48 (12.5%). .Conclusion:1, Laparoscopic hysterectomy, the postoperative complications was low, less blood loss, intestinal function recovery time is short, a small incision scar, shorter hospital stay.2, Laparoscopic hysterectomy surgery using monopolar electrocoagulation in the Palace of tissue coagulation Qie Faqie addition, to prevent line slippage bleeding ligation.3, Improved laparoscopic hysterectomy patients resume a normal life time is short, low incidence of sexual dysfunction to maintain pelvic floor load bearing capacity.4, The doctor should be based on the actual situation in patients with a reasonable surgical options to achieve better therapeutic effect.
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