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KMID : 0386019960080010027
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Korean Journal of Gynecology Endoscopy and Minimally Invasive Surgery
1996 Volume.8 No. 1 p.27 ~ p.35
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The Comparision of Laparoscopic-Assisted Vaginal Hysterectomy with Classic Intrafascial Semm Hysterectomy
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이규완/Lee, KW
김탁/허준용/구병삼/Kim, T/Hur, JY/Ku, PS
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Abstract
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Laparoscopic-assisted vaginal hysterectomy (LAV.H) is a conservative technique that is effective when vaginal hysterectomy is often contraindicated in candidate with such pathology as large myomna, endometriosis, significant pelvic inflammatory disease or severe pelvic adhesion. L.A.V.H. has significantly reduced morbidity and mortality associated with abdominal hysterectomy.. Recently, employing additional technologies, the laparoscopic hysterectomy can now be performed with the supracervical approach (classic intrafacial semm hysterectomy, C.I.S. H.) Pelviscopic intrafascial hysterectomy is an intra6scial cylindrifo--m enudeation of the cervix and supracervical amputation of the uterus, leaving intact the highly vascularized extrafascial cervical tissue, the corresponding nerve by operative pelviscopy. Therefore, for the purpose of evaluating these two surgical procedures, we compared penoperative and postoperative courses of LAV.H. and C.I.S.H. The subjects were 186 women (132 L.A V.H. and 54 CISH) with pelvic pathology unsuitable for vaginal hysterectomy. The average operating time was 124 ±38 minutes for L.A.V.H. and 125±31 minutes for C.I S. H. The average length of hospital stay is 4.2±0.7 days for LAVE. and 2.5±0.8 days for C.I.S.H. Postoperative hemoglobin changes is 16±0.9g / dl for LAVE. and 1.4±0.6g / dl for C.I.S.H. The complication rate is 6.8% for L.A.V.H. and 5.6% for C.I.S.H. There are no significant differences in surgical outcome between LAVE. and C.I.S.H. Thus, we conclude that although long term follow up is pending, these two surgical procedures seem to be appropriate modalities to laparoscopic hysterectomy.
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