[Clinical study on different operation procedure for hysterectomy].
OBJECTIVE: To investigate the effects and outcomes of four procedures for hysterectomy. METHOD: Retrospectively, we analyzed the clinical characteristics of 756 cases who respectively received hysterectomy by total abdominohysterectomy (TAH, 260 cases), modified abdominohysterectomy (MAH, 180 cases), transvaginal hysterectomy (TVH, 106 cases), or laparoscopic assisted vaginal hysterectomy (LAVH) (210 cases) and compared their effects and outcomes. RESULTS: The average operation time of TAH (98 +/- 23) minutes, MAH (67 +/- 18) minutes, TVH (63 +/- 19) minutes and LAVH (99 +/- 35) minutes. The average operation time of LAVH and TAH groups was significantly longer than that of TVH and MAH groups (P < 0.05). The volume of hemorrhage during operation in TAH group (180 +/- 49) ml was much more than that of other three groups significantly [MAH (102 +/- 43) ml, TVH (93 +/- 31) ml, LAVH (111 +/- 39) ml]. The average time of antibiotic administration and bowel function recovery in TAH group [(5.2 +/- 2.6) days, (36 +/- 9) hours] was significantly longer than that of TVH [(3.2 +/- 1.6) days, (21 +/- 4) hours], LAVH [(3.5 +/- 1.9) days, (23 +/- 6) hours] and MAH [(3.3 +/- 1.7) days, (23 +/- 7) hours] (P < 0.05). The incidence of fever in TAH group was significantly higher than that of other three groups also. The average hospital stay after operation in TVH [(3.3 +/- 1.2) days] and LAVH [(3.6 +/- 1.1) days] groups was significantly shorter than that of MAH [(5.6 +/- 1.9) days] or TAH [(5.4 +/- 2.3) days] groups (P < 0.05). CONCLUSIONS: Different procedures for total hysterectomy have their own advantages and disadvantages. Microinvasive surgery by laparoscopy for hysterectomy will be mainstream in the future.