Comparative Analysis Of Three Different Ways To Hysterectomy

Objective:To compare and analyse the clinical effects, advantages, disadvantages and its safety feasibility through the ways of vaginal,abdominal or laparoscopic to operate on hysterectomy.Methods:327hysterectomy patients were recruited (2009Jan to2012Jan) according to some choices and standards from the maternal and child care service center of Tanggu, and were divided into Vaginal hysterectomy (TVH)(182cases), abdominal hysterectomy (TAH)(95cases) and laparoscopic hysterectomy (LH)(60cases).Otherwise,the patients of vaginal hysterectomy were divided into Ligasure (91cases) and traditional suture way (91cases). All patients with internal medicine disease, surgical complications or other diseases were excluded. Who can withstand the surgery should do routine preoperative tests, suspected diagnosis of endometrial lesions with curettage to exclude reproductive cancer, and to be proved simple uterine diseases. General clinical information, number of delivery and postoperative recovery time of intestinal function, the average duration of surgery, intraoperative blood soss, with and without postoperative complications, uterus size, previous gynecologic operation history, length of stay, hospital cost, etc were statistical by specialist. And then use statistical software to process statistical analysis. Use Chi-square to compare the numeration date, such as whether have previous gynecologic operation history, etc, P<0.05with statistically significant.Results:Use the ways of transvaginal,laparoscopic and abdoimal to process the hysterectomy, the results suggest that preoperative patients are general not much difference. In the postoperative recovery of intestinal function, duration of surgery, length of stay and postoperative complications, TVH group were significantly better than TAH Group (P<0.05), but TVH Ligasure Group hospitalization costs were more than the TAH Group (P<0.05). Although TLH operation requires a long time, TLH group compared with TVH group has certain advantages in areas such as in the postoperative recovery of intestinal peristalsis, postoperative hospitalization time and bleed (P<0.05). The time of TVH surgery was significantly reduced after application of Ligasure (P<0.05), which therefore improved operation efficiency and reduce the intraoperative bleeding from the operation of TLH group and TVH group, while it increased the costs of operation.Conclusions:We firstly should choose the most beneficial surgery for patient to furthest minimize the patients’suffering. TVH is the most receptive surgery among patients, because it has such advantages as small surgical trauma, short recovery time, less surgical complications in postoperative, and so on, thus it has become the preferred technique of benign uterine lesions. The three operations cannot completely replace each other. Any operation requires ensuring the safety and efficiency in order to improve its speed. Moreover any operation has its advantages and disadvantages, and so we should comprehensively consider this combined with the patient’s own situation, technology level, and the condition of the hospital. The training of vaginal and laparoscopic minimally invasive surgery is also very important, the training should pay attention to increase experiences of the young doctors in minimally invasive surgery and expand the proportion of minimally invasive surgery. Ligasure expanded the applying scope of vaginal hysterectomy surgery, and the situation of intraoperative mass bleeding is improving as well. Vaginal hysterectomy can use the female natural channel with several advantages such as low rates of postoperative disease, gastro-intestinal tract is almost not disturbed intestinal function recovery after operation of more minor, and less postoperative complications, postoperative pain, short duration of surgery, shorter hospital stay and beautiful no scar of abdominal wall and so on, which have a wide range of applications. As the new surgical instruments updating constantly widely applying in clinical, the safety and efficiency of the surgery will be improved, which avoid the health risks, and thus make the surgical indications expanded.