| Objective: To study the efficacy of modified laparoscopic total hysterectomy,transabdominal total hysterectomy and laparoscopic total hysterectomy in the treatment of giant hysteromyoma,providing reference basis for clinical treatment of giant hysteromyoma.Methods : A total of 126 patients with large uterine fibroids were selected as study subjects,all of whom were hospitalized from April 2015 to August 2017.They were divided into three groups according to treatment methods: group A(42 cases),group B(42 cases),and group C(42 cases).Among them,transabdominal total hysterectomy was selected for group A,laparoscopic total hysterectomy for group B and modified laparoscopic total hysterectomy for group C.The intraoperative blood loss,intraoperative specimen weight,operation time,surgical cost,postoperative hospital stay,postoperative analgesic use rate,postoperative anal exhaust time,incidence of complications,first class abdominal wound healing rate,incidence of vaginal stump granulation and postoperative quality of life score were compared among the three groups of patients with large uterine fibroids.Results:(1)Surgery time.The mean operative time of group A,B and C was successively(89.41 ± 21.58)min,(105.85 ± 25.63)min,and(90.09 ± 22.16)min.Compared with group B,the operative time of group A and group C was significantly shorter,and the difference was statistically significant(P < 0.05).There was no difference in operation time between group A and group C,with no statistical significance(P > 0.05).(2)Intraoperative blood loss.The mean intraoperative blood loss in group A,B and C was(171.41 ± 36.75)ml,(120.63 ± 34.47)ml and(97.45 ± 27.93)ml.Compared with group A,group B and group C,the mean intraoperative blood loss was significantly less,and the difference was statistically significant(P < 0.05).Compared with group B,the mean intraoperative blood loss in group C was significantly less,and the difference was statistically significant(P < 0.05).(3)Intraoperative specimen weight.The intraoperative specimens in group A,group B and group C were successively weighed(507.64 ± 15.08)g,(506.15 ± 14.82)g,(505.79 ± 15.26)g.There was no significant difference in intraoperative specimen weight between the three groups,and no statistical significance(P > 0.05).(4)The cost of surgery.The average cost of surgery in group A,B and C was in the order of 9041.55 ± 463.94,12228.74 ± 551.96,and 11074.61 ± 529.38.Compared with group B and C,the average cost of surgery in group A was significantly lower,and the difference was statistically significant(P < 0.05).Compared with group B,the average cost of surgery in group C was significantly lower,and the difference was statistically significant(P < 0.05).(5)Postoperative wound healing rate of abdominal operation.In group A,group B and group C,the first healing rate of abdominal operation was 90.47%,92.85% and 100%,respectively.There was no significant difference in the postoperative abdominal wound healing rate between the three groups(P > 0.05).(6)Postoperative analgesic use rate.The rate of analgesic use was 71.43%,38.09% and 28.57% in group A,group B and group C.Compared with group A,the rate of postoperative analgesic use in group B and C was significantly lower,with statistically significant differences(P < 0.05).There was no significant difference in postoperative analgesic use between group B and group C,and no statistical significance(P > 0.05).(7)Postoperative anal exhaust time.Postoperative anal exhaust time in group A,group B and group C was,in order,(39.43 ± 6.74)h,(26.83 ± 5.02)h,(25.95 ± 4.16)h.Compared with group A,the postoperative anal exhaust time was significantly shorter in group B and C,and the difference was statistically significant(P < 0.05).There was no significant difference in postoperative anal exhaust time between group B and group C,with no statistical significance(P > 0.05).(8)Postoperative hospital stay.Postoperative hospital stay in group A,group B and group C was in order(7.03 ± 1.16)d,(4.54 ± 1.07)d,(4.28 ± 1.01)d.Compared with group A,group B and C had significantly shorter postoperative hospital stay,and the difference was statistically significant(P < 0.05).There was no significant difference in postoperative hospital stay between group B and group C,with no statistical significance(P > 0.05).(9)Postoperative morbidity of vaginal stump and complications.The incidence of postoperative vaginal stump granulation in group A,group B and group C was respectively 28.57%,21.43% and 2.38%.There was no significant difference in the incidence of postoperative vaginal stump granulation between group A and group B,with no statistical significance(P > 0.05).Compared with group A and B,the incidence of postoperative vaginal stump granulation in group C was significantly lower,with statistically significant differences(P < 0.05).The incidence of complications in group A,B and C was 11.90%,9.52% and 4.76% respectively.There was no significant difference in the incidence of complications between the three groups,with no statistical significance(P > 0.05).(10)Quality of life scores.There was no difference in preoperative quality of life scores among the three groups of patients with large uterine fibroids(P > 0.05).Compared with group A,the postoperative quality of life score of group B and C was significantly higher,and the difference was statistically significant(P < 0.05).There was no difference in postoperative quality of life scores between group B and group C,with no statistical significance(P > 0.05). |
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