Clinical Effect of Abdominal Total Hysterectomy on Uterine Fibroids and Serum VEGF, IL-6 and IL-8 Levels / 现代生物医学进展

Objective:To research the clinical effect of abdominal total hysterectomy on the patients with uterine fibroids and the serum vascular endothelial growth factor (VEGF) and interleukin 6 (IL-6),interleukin 8 (IL-8) levels.Methods:106 cases of patients with uterine fibroids from February 2014 to February 2016 were divided into the control group and the research group according to the lottery method,the control group was treated with total abdominal hysterectomy,while the research group was given abdominal total hysterectomy treatment,the operation time,blood loss,anal exhaust time,length of hospital stay,changes of serum VEGF,IL-6,IL-8,Follicle stimulating hormone (FSH),estradiol (E2) levels,resistance to seedling le tube hormone (AMH) before and after the surgery as well as the occurrence of complications were compared between two groups.Results:The operation time,blood loss,length of hospital stay,anal exhaust time of research group were significantly shorter than those of the control group (P＜0.05).Before surgery,the serum levels of VEGF,IL-6,IL-8,FSH,E2,AMH showed no difference between two groups (P＞0.05).After the operation,the serum levels of IL-6,IL-8,E2,AMH of research group were lower than those of the control group (P＜0.05),the serum level of FSH in research group was higher than that of the control group (P＜0.05).The serum level of VEGF showed no difference between the two groups (P＞0.05).The incidence rate of complications in research group was lower than that of the control group (P＜0.05).Conclusion:Abdominal total hysterectomy showed similar effect with the abdominal hysterectomy in the treatment of uterine fibroids patients,but the abdominal full hysterectomy induced less trauma,promoted the recovery of ovarian function after surgery,which might be related to the decrease of serum IL-6,IL-8 and VEGF levels.

Algunos resultados de la histerectomía total abdominal & histerectomía subtotal abdominal en pacientes con diagnóstico de mioma uterino / Some results from the abdominal total and subtotal hysterectomy in patients diagnosed with uteri myoma

La controversia entre todas las formas de histerectomías y sus diferentes abordajes se ha agudizado, ha llegado a las propias pacientes que con frecuencia creciente solicitan información del ginecólogo, llegan a exigir la histerectomía subtotal abdominal (HSTA) por la ventajas que han oído o leído sobre ella. OBJETIVO: Analizar comparativamente resultados obtenidos entre la histerectomía total abdominal (HTA) y la histerectomía subtotal abdominal (HSTA), según variables seleccionadas. MÉTODOS: Se realizó un estudio descriptivo retrospectivo longitudinal en el periodo comprendido entre enero 2002 a diciembre 2004 en el Hospital Ginecoobstérico Docente Ramón González Coro. La muestra estuvo constituida por un total 310 pacientes histerectomizadas con el diagnóstico de mioma uterino para lo cual seleccionamos dos grupos. Para investigar la posible asociación entre variables cualitativas se utilizó la prueba chi², se consideraron diferencias significativas en aquellos casos donde p = 0,05. RESULTADOS: La HSTA tuvo menor tiempo quirúrgico para un 83,9 por ciento (p=0,000), así como una menor estadía hospitalaria para un 58,1 por ciento, el sangramiento moderado fue de un 5,1 por ciento en la HSTA, no se encontraron lesiones a órganos vecinos en ambos grupos, y la morbilidad febril e infecciosa fue mayor para el grupo de la HTA para un 22,4 por ciento y 5,7 por ciento respectivamente. CONCLUSIONES: En nuestro estudio la histerectomía subtotal abdominal comparativamente con la histerectomía total abdominal tuvo menor tiempo quirúrgico, estadía hospitalario y menor número de complicaciones transoperatorias y posoperatorias

Controversy among all the ways of hysterectomies and the different approaches has increased is known by patients that frequently request information to gynecologists on their criterion of an abdominal subtotal hysterectomy (ASTH) due its advantages of this technique. OBJECTIVE: To analyze comparatively the results obtained among the abdominal total hysterectomies (ATH) and the ASTH according the variables selected. METHODS: A cross-sectional, retrospective and descriptive was conducted from January, 2002 to December, 2004 in the Ramón Pando Ferrer Genecology-Obstetricts Hospital. Sample included 310 patients with hysterectomy diagnosed with a uterine myoma divided into two groups. To research the possible association among qualitative variable the chi² test was used with significant differences en those groups where (p =0.05). RESULTS: The ASTH had less surgical time for a 83.9 percent (p = 0,000), as well as a lower hospital stay for 58.1 percent; moderate bleeding was of a 5.1 percent in the ASTH without lesions of surrounding organs in both groups and febrile and infectious morbidity was greater for the ATH group for a 22.4 percent and 5.7/5, respectively. CONCLUSIONS: In our study the abdominal subtotal hysterectomy (ASBH) compared with the abdominal total hysterectomy (ATH) has less surgical time, hospital stay and a lesser number of transoperative and postoperative complications

Comparison of Postoperative Pain after Abdominal and Laparoscopic Assisted Vaginal Hysterectomy by using IV-PCA / 대한마취과학회지

BACKGROUND: It is known that laparoscopic surgery is associated with less pain than open surgery in many studies. We wanted to evaluate the postoperative pain by using intravenous patient-controlled analgesia (IV-PCA) in patients undergoing laparoscopic assisted vaginal hysterectomy (LAVH) or abdominal total hysterectomy (ATH). METHODS: Ninety one women with uterine myoma were prospectively assigned to undergo either LAVH (n = 49) or ATH (n = 42). IV-PCA was used for postoperative pain control in both groups. Pain scores were assessed using a visual analogue scale (VAS) and cumulative PCA-drug consumption and incidences of nausea and vomiting were recorded in 1, 2, 4, 24, 48 hours after surgery. RESULTS: There were no differences in terms of patient's age, BMI and total operation time between the both groups. Pain scores and the demand of analgesics of the IV-PCA in 1, 2, 4, 24, and 48 hours after surgery were not significantly different in both groups. Incidences of nausea and vomiting after surgery were more common in LAVH than ATH especially within 4 hours. CONCLUSIONS: The present study demonstrates that LAVH requires adequate postoperative pain control as ATH during the first 48 hours after surgery, and the effective prevention of PONV is required in LAVH compared with ATH.