Comparison Of Different Surgical Methods Of Total Hysterectomy For Hysteromyoma

objective:to compare the clinical effects of three different surgical methods of total hysterectomy in the treatment of uterine fibroids,and to provide an optimal surgical method for patients.Methods:from November 2017 to February 2019,220 patients in the department of obstetrics and gynecology of the first affiliated hospital of bengbu medical college were selected to undergo total hysterectomy and bilateral salpingectomy for uterine fibroids.According to different surgical methods,they were divided into the laparoscopic total hysterectomy group(LH group:uterus<Pregnancy 12 weeks,uterus?Pregnancy 12 weeks),vaginal total hysterectomy group(TVH group:uterus<Pregnancy 12 weeks),the total abdominal hysterectomy group(TAH group:uterus<Pregnancy 12 weeks,uterus? Pregnancy 12 weeks),comparing the indexes of three groups:The total operation time,intraoperative blood loss,postoperative ventilation time,postoperative hospital stay,postoperative inflammatory indexes and complications,and ovarian function.Results:uterus<Pregnancy 12 weeks:in terms of intraoperative blood loss,postoperative exhaust time and postoperative length of hospital stay,postoperative inflammatory indicators,TAH group>LH group.TVH group;There were statistically significant differences between the TAH group and TVH group,TAH group and LH group(P<0.05),there was no statistical difference between the TVH group and the LH group(P>0.05).In terms of operation time:TVH group<TAH group<LH group,there was no significant statistical difference between the groups(P>0.05).uterus?Pregnancy 12 weeks:operative time and intraoperative blood loss in the two groups:TAH group<LH group,there was a statistical difference(P<0.05);Comparison of postoperative exhaust time,postoperative hospital stay and postoperative inflammatory indicators:TAH group>LH group;There were statistically significant differences(P<0.05).and postoperative ovarian function:Postoperative ovarian function of the patients decreased compared with that before surgery,and TAH was the most injured,with a statistical difference(P<0.05);postoperative abdominal incision infection and poor healing occurred in TAH group.Conclusions:(1)in the case that all three surgical methods of total hysterectomy are feasible,when the uterus<pregnancy 12 weeks:the surgical effect of TVH was better than that of TAH and LH,with fewer complications.Secondly,LH is preferable to TAH in that it has the advantages of smaller wound mouth,faster recovery and less pain,although LH has a longer operation time.When the uterus?pregnancy 12 weeks,TAH has the advantages of short operation time,easy operation and less bleeding,which are more desirable.(2)treatment should be individualized,and minimally invasive treatment should not be blindly pursued to increase the medical burden;(3)TAH is the preferred surgical method for clinically difficult cases.