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Objective To investigate the effect of total laparoscopic hysterectomy (LTH) and laparoscopic assisted vaginal hysterectomy (LAVH) for hysterectomy. Methods From February 2015 to February 2017, 182 patients with total hysterectomy were enrolled, among them, LTH was performed in 97 patients, and LAVH was performed in 85 patients, the operation time, intraoperative blood loss, the length of scar, postoperative anal exhaust time and so on were observed in the two groups, C reactive protein (CRP), interleukin -2 (IL-2) and IL-6 were detected before and after operation in two groups. Results In group LTH, the amount of bleeding and the length of scar were (104.33 ± 40.20) ml and (2.03 ± 0.84) cm respectively, which were significantly lower than those in group LAVH (P < 0.05); There was no significant difference between LTH group and LAVH group in postoperative anal exhaust time, hospital stay, postoperative analgesia and hospitalization costs (P > 0.05); The CRP and IL-6 in the LTH group postoperative were (26.43 ± 6.11) mg/L and (40.04 ± 11.03) ng/ml, significantly lower than those in LAVH group (P < 0.05), while IL-2 was (44.20 ± 12.29) ng/ml, was significantly higher than that of the control group (P < 0.05); The incidence of postoperative complications in LTH group was 6.19%, which was significantly lower than that of LAVH group (P < 0.05). Conclusion LTH is a safe and reliable method for hysterectomy, has the advantages of less complications, less influence on immune function and so on, is worthy of clinical application.
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Objective To compare the effects of transabdominal hysterectomy(TAH),transvaginal hysterectomy(TVH),and laparoscopic total hysterectomy(LTH)on sexual function and psychological health.Methods A total of 100 patients undergoing TAH,100 patients undergoing TVH,and 40 patients undergoing LTH were followed up for 1 year.All the patients were aged between 45 and 54 years.The Results of the questionnaire on sexual function and psychological health were analyzed and compared with those from 100 control subjects undergoing hysteromyomectomy.Results In pateints under 50 years of age,no significant difference in the sexual function and psychological health was found between control group and any one of TAH,TVH,and LTH goups.In patients aged 50 yeare and older.ESFI score decreased from control group to TVH group to LTH group to TAH group;CHQ-12 score increased from control group to TVH group to LTH group to TAH group;and there was significant difference in the FSFI and CHQ-12 scores both between TAH and control groups and between TAH and TVH groups(P＜0.05).Conclusion There is no obvious effect of these 3 surgical approches to hysterectomy on the sexual function and psychological health in patients under 50 years of age,and there is no significant difference in the sexual function and psychological health among these 3 surgcial approaches.In patients aged 50 yean;and older,TAH has a negative impact on the psychological health and sexual function.
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BACKGROUND: Postoperative pain degree is variable according to the site, type, and method of operation. This study compared the pain degree and amount of analgesics required among 3 types of operation. METHODS: Ninety patients were selected that cesarean section (Group I, n = 30), open total hysterectomy (Group II, n = 30), laparoscopic total hysterectomy (Group III, n = 30) were scheduled. Patients received PCA with basal rate 2 ml/h, bolus 1 ml, lockout interval 5 min using fentanyl and ketorolac. We evaluated VAS at 30 min, 2, 6, 12, 18, 24, 36, 48 h postoperatively, demand of button and attempt of button, 6 hourly used amount of analgesics; side effects and degree of satisfaction after 24, 48 h postoperatively. RESULTS: The rest VAS decreased below 30 at 6 hr in group I & II and at 2 hr in group III. More analgesics were needed for the first 6 hr compared with remained time in 3 groups (group I vs. group II vs. group III, P < 0.05). Total amount of analgesics including loading dose were fentanyl 1,536 +/- 342microgram, ketorolac 167 +/- 34 mg for group I; 1,212 +/- 215microgram, 132 +/- 30 mg for group II; 866 +/- 125microgram, 97 +/- 27 mg for group III (group I vs. group II vs. group III, P < 0.05). CONCLUSIONS: The postoperative pain was painful as order of cesarean section, open total hysterectomy, and laparoscopic total hysterectomy. The pain was reduced 6 hr in laparotomy and 2 h in laparoscopy.