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经阴道子宫切除及阴道前、后壁修补术的改进

吉林医学 1989年第1期10卷 62-62页

作者：高淑仙徐国翠马淑芬白城地区医院妇产科白城地区医院保健科

手术步骤:取膀胱截石位,按常规麻醉,消毒后,钳拉宫颈向外,用金属导尿管固定膀胱在宫颈前壁的附着线,于其下方0.5cm处,横行切透阴道粘膜,并在膨出的阴道前壁划定所需要切除的范围。切断并结扎两侧膀胱支柱并将其推向上方,暴露并切开膀胱... 详细信息

手术步骤:取膀胱截石位,按常规麻醉,消毒后,钳拉宫颈向外,用金属导尿管固定膀胱在宫颈前壁的附着线,于其下方0.5cm处,横行切透阴道粘膜,并在膨出的阴道前壁划定所需要切除的范围。切断并结扎两侧膀胱支柱并将其推向上方,暴露并切开膀胱,反折腹膜进入腹腔。

关键词：阴道子宫切除阴道前壁子宫主韧带阴道粘膜反折腹膜重叠缝合导尿管卵巢悬韧带双侧子宫腹膜切口

eVALuate研究:经腹腔镜与开腹和经阴道子宫切除术相比较的两项平行随机试验

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中华妇产科杂志 2005年第9期40卷 46-46页

宫腔镜下内膜切除与腹腔镜辅助下的经阴道子宫切除术治疗月经过多的比较

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世界医学杂志 1999年第2期3卷 25-25页

作者： Tapp.,AM Mei.,PK

经阴道和经腹子宫切除术治疗老年子宫内膜癌效果的比较

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世界核心医学期刊文摘（妇产科学分册） 2005年第6期1卷 45-46页

作者： Susini T. Massi G. Amunni G. 张家墅程金湘 Department of Gynecology Perinatology and Human Reproduction University of Florence Florence Italy

The purpose of this study was to analyze the outcome of vaginal and abdominal hysterectomy for treatment of endometrial cancer in elderly patients. In a retrospective series of 171 patients with age ≥ 70 years and at stages I- III, we evaluated operative and hospitalization data, as well as morbidity, mortality, and long- term survival associated with vaginal and abdominal hysterectomy. A total of 128 patients were operated on with vaginal hysterectomy and 43 cases underwent abdominal hysterectomy. Medically compromised patients were significantly more frequent in the vaginal surgery group (P = 0.01). Overall, the 10- year disease- specific survival rates after vaginal and abdominal hysterectomy were 80% and 78% , respectively (P = n.s.). Limiting the analysis to stage I (130 patients), 10- year disease- specific survival was 83% in 95 women operated on by the vaginal route and 84% in 35 patients operated by the abdominal approach (P = n.s.). Patients in the vaginal surgery group had a significantly shorter operative time (P = 0.01), less blood loss (P< 0.05), and were discharged earlier (P < 0.05). Severe complications occurred in 5.4% of the vaginal and in 7.0% of the abdominal procedures. Perioperative mortality was zero after vaginal hysterectomy and 2.3% after abdominal hysterectomy, respectively. Vaginal hysterectomy showed a high cure rate, shorter operative time, less blood loss, reduced morbidity, and no mortality and therefore may be considered the elective approach for treatment of elderly patients with endometrial cancer.

关键词：老年子宫内膜癌经腹子宫切除术阴道手术阴道子宫切除经腹手术长期存活率手术记录临床分期失血量围手术期

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学习腹腔镜辅助的子宫切除术

世界核心医学期刊文摘（妇产科学分册） 2005年第9期1卷 38-39页

作者： Altgassen C. Michels W. Schneider A. 宁亮 Department of Obstetrics Univ. Hospital of Schleswig -Holstein Campus Lbeck Ratzeburger Allee 160 23538 Lbeck Germany Dr.

OBJECTIVE: The aim of this study was to evaluate the factors considered for pr oficiency and to estimate the number of procedures needed to achieve competence in laparoscopic-assisted vaginal hysterectomy in a teaching hospital. METHODS: The length of the learning curve, duration of surgery, change of hemoglobin (in grams per liter), conversion rate, and intra-and postoperative complications we re evaluated. Cases were analyzed according to the order for the individual surg eon. RESULTS: Thirty-three surgeons performed 929 laparoscopic-assisted vagina l hysterectomies during the study period. Analyzing the duration of surgery and rate of complications, we decided on a cutoff of 30 cases. Eight surgeons with m ore than 30 cases performed 668 laparoscopic-assisted vaginal hysterectomies. T heir initial 30 cases (group A, the first 30 cases) were compared with their subsequent cases (group B, cases 31 and after). Patient age, body mass index, and uterine weight did not differ b etween the groups. The intraoperative complication rate dropped from 4.2%to 0.5 %(P = .001), hemoglobin drop decreased from -0.8 ±0.9 g/L to -0.5 ±.1.0 g/L (P = .002), and postoperative complications dropped from 12.9%to 7.0%(P = .01 7). The duration of surgery was also shorter (148.8 ±45.4 minutes versus 125.1 ±46.5 minutes), but this difference was taken from the results of 1 surgeon. CO NCLUSION: A learning experience of 30 laparoscopic-assisted vaginal hysterectom ies was necessary in our institution to reach a low level of complications. Dura tion of the surgical procedure was not an adequate study endpoint to assess a le arning effect.

关键词：子宫切除术腔镜经阴子宫切除阴道子宫切除术后并发症手术时间经腹手术妇产科医生子宫重量教学医院

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比西发定的Ⅲ期临床开始进行

国外药讯 2006年第1期 18-18页

作者：贾永蕊（摘）

总部设在美国新泽西的DOV制药公司已开始该公司非麻醉性止痛新药比西发定（bicifadine）（Ⅰ）治疗阴道子宫切除手术后疼痛的Ⅲ期临床试验。

关键词： Ⅲ期临床试验发定阴道子宫切除制药公司手术后疼痛麻醉性止痛新泽西