非下降阴道子宫切除术(Ndvh):良性子宫疾病的一种有前途的手术技术

Ruby Reja
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摘要

背景:子宫切除术是世界上最常见的妇科手术之一,包括腹部手术、阴道手术、腹腔镜手术和机器人手术。几年前引入并实施的阴道技术由于缺乏经验和妇科医生的热情而不太成功,因为他们错误地认为腹部路径更安全,更容易。目的:探讨最有效、最合适的子宫切除途径,比较非下降式阴道子宫切除术与腹式子宫切除术术中、术后并发症。材料与方法:本回顾性研究于2020年10月至2021年12月在Sagar Khemchand Jain医院因良性子宫疾病行子宫切除术的60名妇女,其中30名妇女行非下降阴道子宫切除术,30名妇女行全腹子宫切除术。结果:两组患者基线特征相似,均无术中并发症。在手术时间、术中出血量、术后疼痛、术后输血、术后活动、术后伤口感染、发热发病率、住院时间等方面,阴道子宫切除术的p值显著高于腹部子宫切除术。术后系统性感染p值差异无统计学意义。阴道组无一例转腹,整个研究组无一例再开腹手术。结论:良性非脱垂需要子宫切除术的患者可选择阴道子宫切除术,因为阴道子宫切除术比腹部子宫切除术恢复快,住院时间短,手术和术后发病率低。
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Non-Descent Vaginal Hysterectomy (Ndvh): A Promising Surgical Technique in Benign Uterine Disorders
Background: Hysterectomy, one of the most common gynaecological surgeries performed around the world, has many techniques including abdominal, vaginal, laparoscopic and robotic. The Vaginal technique which was introduced and performed eras back has been less successful due to lack of experience and eagerness among gynaecologists because of a misconception that the abdominal route is safer and is easier. Aims and Objectives: Evaluation of most efficient and suitable route of hysterectomy.comparison between intraoperative and postoperative complications in non descent vaginal hysterectomy and abdominal hysterectomy. Materials and Methods: This retrospective study was conducted during the period from October 2020 to December 2021, it studied 60 women who underwent hysterectomy for benign uterine disorder at Khemchand Jain Hospital, Sagar, out of which 30 women underwent non descent vaginal hysterectomy and 30 women underwent total abdominal hysterectomy. Result: Baseline characteristics were similar between the two groups with no intraoperative complications in either. Regarding operation duration, intraoperative blood loss, post-operative pain, post-operative blood transfusion, mobilization in post-operative periods, post-operative wounds infection, febrile morbidity, duration of hospitality stay, P-value was significant in vaginal hysterectomy when compared to abdominal hysterectomy. Regarding post-operative systematic infection, P-value was not significant. None of the cases in the vaginal group were converted to abdominal route and none of the cases in the whole study group underwent relaparotomy. Conclusion: The study concludes that patients requiring hysterectomy for benign non prolapse cases may be given the option of vaginal hysterectomy because it has quicker recovery, shorter hospitalization, lesser operative and post-operative morbidity compared to abdominal route.
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