Obstetrics & gynecology science

Korean Society of Obstetrics and Gynecology (대한산부인과학회)
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Total Laparoscopic Hysterectomy (TLH) : A Clinical Review of 300 Cases

Total Laparoscopic Hysterectomy (TLH) : 300예의 임상분석

Kim, Yeon-Ju;Ha, Boo-Soo;Lee, Beum-Deuk;Lee, Jong-Keun;Son, Yong-Seuk;Chugh, Yoon-Won
김연주;하부수;이범덕;이종근;손용석;조윤원

  • Published : 20020200
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Abstract

This clinical study was conducted to survey 300 cases of total laparoscopic hysterctomy (TLH) by the Department of Obstetrics and Gynecology of Boram Hospital in Ulsan, Korea from January, 2000 to June, 2001. TLH has been described in much of the recent literature. We analyzed 300 cases of TLH to evaluate the clinical data such as distribution of age, parity, clinical indication, previous operation history, type of surgery, operation time, weight of uterus, Hb change of post-operation first day and the complications of using this technique. The mean age of patients was 41.3. The mean parity of patients was 2.6. The clinical indications for TLH were myoma (72.3%), adenomyosis (11.3%), PID (5.3%), CIS (4%) and others (5.7%). The most previous operation was bilateral tubal ligation. Others were cesarean section, appendectomy. The most concomitant procedure with TLH was posterior colpoperineorrhaphy. Salpingo-oophorectomy and appendectomy were also carried out concomitantly. The mean operation time was 124 minutes. The mean weight of the uterus was 230 gm. The mean Hb change post-operation on the 1st day was 1.3 g/dL. The complications of TLH were bleeding to need blood transfusion, ureteral injury and bladder injury. Thus this technique can be safely performed by skilled laparoscopists for properly selected patients but there is a need for prospective studies for comparision with various laparoscopic hysterctomies.

목적 : 복강경을 이용한 자궁적출술중 최근에 많이 이용되고 있는 복강경하 전자궁적출술 (total total laparoscopic hysterctomy, TLH)의 유용성과 환자의 나이, 출산력, 임상 적응증, 과거수술 기왕력, 동반된 수술종류, 수술시간, 자궁의 크기, 수술후 출혈량, 합병증에 대하여 비교 및 고찰하고자 하였다. 연구 방 법 : 2000년 1월부터 2001년 6월까지 울산 보람병원 산부인과에서 상기 술식으로 시행한 300예를 대상으로 하였다. 결론 : 본 산부인과에서는 2000년 1월부터 2001년 6월까지 300예의 TLH를 경험하였으며, 이 수술방법의 기술적 어려움은 적절히 환자선택을 잘하여 숙달된 laparoscopists에 의해 시행되면 안전하게 시술될 수 있고, 앞으로 복강경하 자궁적출술의 수술기법으로 LAVH와 함께 많이 시행되어 질 것으로 사료된다. 또한 이 수술 방법의 정확한 평가를 위해 앞으로 더 많은 예에서의 고찰 및 장기적인 수술 후 결과에 대한 추적관찰과 LAVH와의 전향적인 비교연구가 필요할 것으로 사료된다.

Keywords

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