Influence of previous abdominal surgery on clinical outcomes of patients undergoing total laparoscopic hysterectomy.
Influence of previous abdominal surgery on clinical outcomes of patients undergoing total laparoscopic hysterectomy.
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DOI：
10.5468/ogs.2018.61.3.379
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发表时间：
2018-05
影响因子：
--
通讯作者：
Lim S
中科院分区：
文献类型：
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作者：
Seo ES;Lee SH;Chon SJ;Jung SY;Cho YJ;Lim S
评估既往腹部手术对全腹腔镜子宫切除术（TLH）术后结果和并发症发生率的潜在影响。 2008年6月至2016年12月期间，对331名接受TLH的患者进行了回顾性分析。参与患者根据既往腹部手术情况分为两组。我们根据估计失血量、手术时间、住院时间、手术相关并发症以及转剖腹手术率对两组进行比较。第 1 组包括没有腹部手术史的患者 (n=186)，第 2 组包括有腹部手术史的患者 (n=145)。第 1 组的并发症发生率为 3.2%，第 2 组为 2.8%。其他术后结果和并发症（例如估计失血量、住院时间和转剖腹手术率）在各组之间没有显着差异。第 2 组中粘连溶解明显更常见（P<0.001），第 2 组手术时间明显更长（P=0.004）。第 2 组中转开腹手术的比率较高，但差异并不显着（P=0.115）。第2组患者根据手术次数分为亚组。在第 2 组的亚组分析中，有 70 名患者既往接受过一次腹部手术，75 名患者既往接受过 2 次或以上手术。此外，粘连松解（P=0.004）和转剖腹手术（P=0.034）之间存在显着差异。亚组分析中观察到的其他并发症没有显着差异。无论以前是否接受过腹部手术，TLH 都可以成功进行。既往接受过腹部手术的患者是 TLH 的合适且可行的候选者。
To evaluate the potential effects of previous abdominal surgery on post-operative outcome and incidence of complications after total laparoscopic hysterectomy (TLH). Between June 2008 and December 2016, 331 patients who underwent TLH were retrospectively reviewed. Participating patients were divided into 2 groups according to previous abdominal surgery. We compared the 2 groups based on estimated blood loss, operation time, hospital stay, surgery-related complications, and conversion to laparotomy rates. Group 1 included patients without a history of abdominal surgery (n=186), group 2 included patients with a history of abdominal surgery (n=145). The complication rate was 3.2% in group 1 and 2.8% in group 2. Other post-operative outcome and complications such as estimated blood loss, hospital stay and conversion to laparotomy rates did not differ significantly between groups. Adhesiolysis was significantly more common in group 2 (P<0.001) and operation time was significantly longer in the group 2 (P=0.004). The rate of conversion to laparotomy was higher in group 2, but this difference was not significant (P=0.115). Group 2 patients were divided into subgroups according to the number of surgery. In subgroups analysis of group 2, there were 70 patients who had one previous abdominal surgery and 75 patients who had 2 or more previous surgeries. Moreover, there were significant differences in adhesiolysis (P=0.004) and conversion to laparotomy (P=0.034). There were no significant differences in other complications observed upon subgroup analysis. TLH can be conducted successfully regardless of previous abdominal surgery. Patients with previous abdominal surgery are suitable and feasible candidates for TLH.