Clinical Assessment For Different Routes Of Hysterectomy.

objective:The study was desinged to analyze transvaginal hysterectomy, laparoscopic hysterectomy and transabdominal hysterectomy clinically, and to evaluate the clinical effect, the advantage and the disadvantage, safety and feasibility of these hysterectomy.Methods:Retrospective analysis the hysterectomy (supracervical hysterectomy and total hysterectomy) in the Second Clinical Hospital of Jinlin University from January 2009 to June 2010.According some standards of choice and exclusion,889 cases finally were remained. Patients'age, parity, uterus volume, previous pelvic surgery, time for surgery, blood loss, post-operative need of analgetics, hospital stay and complications were gathered statistics.Also, total transvaginal hysterectomies were separated to two teams:Ligasure and traditional ligature.Time for surgery and blood loss were calculated. The statistical analysis was conducted by the means of SPSS13.0 Package. Comparisons for continuous variables were based on the test of ANONA anlysis, and comparisons between two variables were based on LSD(Least Significant Difference Test) and SNK(Student Newman Kuels Test).Eategorical variables were based on the chi square test.Results:There are no conspicuous differences in the general conditions (patients'age, parity, uterus volume and previous pelvic surgery) among transvaginal hysterectomy, laparoscopic hysterectomy and transabdominal hysterectomy. Transvaginal hysterectomy has the advantages of shorter operation time, recovery faster, less pain after operation, less average time stay at hospital after operation, compared with transabdominal hysterectomy (P＜0.05).Laparoscopic hysterectomy also has the advantage of less time of hospital stay after operation and aerofluxus, less pain after operation (P<0.05), but its time for surgery is longer, bleeding during operation is more.The use of Ligasure decrease the surgery time of transvaginal hysterectomy (P<0.05), and it doesn't change the bleeding quantity obviously (P>0.05)Conclusions:1,In the condition of safety and feasibility, patients'pathogenetic condition and will, doctors'experience and equipment in hospital can help to choose the route of hysterectomy. It is prior to choose the hysterectomy which is most helpful to patients.Transvaginal hysterectomy has the advantages of less injury, shorter operation time, srecovery faster, and less complication.Patients are satisfied with it.It can be considered as the first choice of uterus benign disease.2,Transvaginal hysterectomy and laparoscopic hysterectomy are less on the percentage of all the hysterectomies.To increase their percent, it is necessary to enhance the training of the doctor, to increase their experiences of vaginal and endoscopic surgery.3,More and more surgical instruments are widely applied to clinical operations.They elevate the safety and feasibility of operations, and enlarge the indication.The use of Ligasure can enlarge the indication of transvaginal hysterectomy, improve the conditions of operation and post-operation, and it will has a good future.