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@#Objective To study laparoscopic pelvic lymphyectomy combined with vaginal hystectomy in the treatment of patients with stage Ⅰ endometrial carcinoma.Methods The data of 77 patients with stage Ⅰ endometrial carcinoma were reviewed retrospectively. These patients divided into the laparoscopic group and abdominal group according to the operation style. The operation time, blood loss, postoperation complication, rehabilition of the digestion tract, satisfaction degree to the operation of two groups were compared.Results There was no serious complications in the both groups. In the laparoscopic group, the operation time was longer than the abdominal group ( P<0.01), but so far as to the blood loss, the time of rehabilition of the digestion tract, the number of lymphyectomy, the postoperation pain alleviation and the degree of postoperation depression were superior to the abdominal group ( P<0.01).Conclusion Though the Laparoscopic operation takes longer time than the abdominal operation, it has much more advantage: mimimal blood loss, minimal abdominal scar, rapid postoperation rehabilition, much better pain alleviate, less urine retention.
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OBJECTIVE: The purpose of this study was to evaluate value of laparoscopic assistance during total vaginal hysterectomy, and its implications for hysterectomy method. METHODS: Between January 2001 and December 2001, 236 patients underwent transvaginal hysterectomy (TVH) or Laparoscopic assisted vaginal hysterectomies (LAVH) for benign disease. We compared the results of the two methods, taking account of age, parity, past history of abdominal surgery, surgical indication, operation time, blood loss, presence of pelvic adhesion, weight of uterus, and intra- and post- operative complications and hospital stays. RESULTS: There was no difference in patients' mean age, parity, or menopausal status. Previous operation history was similar between the two groups, except previous cesarean section history. Indications for surgery were similar between the two group. There was no statistical difference on preoperative hemoglobin, postoperative hemoglobin, and 1st day hemoglobin drop. However, mean blood loss checked in operation room was greater for the LAVH group (TVH:113.7+/-83.9 cc, LAVH:146.1+/-113.3 (p<0.05). Uterine weight was heavier in the laparoscopic (249.6 gm) than the vaginal group (214.8 gm) (p<0.05). Mean operating time was shorter in the vaginal (46.5 min) than the laparoscopic group (84.9 min). In laparoscopic group, 15 patients had pelvic adhesions. Four of the 15 patients had adhesions between the posterior surface of the uterus and the bowel, and successful laparoscopic adhesiolysis was achieved in all four cases. CONCLUSION: LAVH have longer operation times and hopital stays than vaginal hysterectomies, but can be safer procedures in patients with possible pelvic adhesions.