当院における過去10年間の良性疾患に対する単純子宮全摘出術の後方視的検討

抄録

Objective: To clarify the trends in outcomes of hysterectomies at our hospital.

Design: A retrospective analysis.

Setting: A city hospital.

Patients: Consecutive women who underwent hysterectomy for benign disease at our hospital from April 1, 2005 to March 31, 2016.

Interventions: hysterectomy±mono/bilateral salpingo-oophorectomy±vaginoplasty.

Main outcome measures: The operating time, intraoperative blood loss, uterine weight, length of hospital stay, and any surgical complications.

Results: Data from 273 abdominal (ATH), 276 laparoscopic assisted (LAVH), 55 total laparoscopic (TLH), and 191 vaginal hysterectomies (VTH) were included. Laparoscopic approaches have increased in the past decade, and vaginal approaches have decreased. The VTH group had shorter operating times than the other procedures and less intraoperative blood loss than the ATH group or LAVH group. In the TLH group, intraoperative blood loss was significantly lower than the other procedures, but the median operating time was the longest. The ATH group had a significantly higher rate of large uteri and moderate to severe complications.

Conclusion: Our experience shows that we require extensive training for vaginal approach hysterectomies with the intent to decrease the operating time, blood loss, complications, and total cost of treatment, while noting that laparoscopic hysterectomy can be considered a standard procedure for benign disease.