복강경하 전자궁절제술에서 자궁의 무게에 따른 이환율의 비교
Comparison of morbidity by uterine weight in total laparoscopic hysterectomy
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목적: 자궁의 무게에 따른 복강경하 자궁절제술의 합병증을 비교 분석하여 복강경하 자궁절제술의 안정성을 알아보고자 하였다. 연구 방법: 2008년 1월부터 2009년 6월까지 본원 산부인과에서 양성 자궁 질환으로 복강경하 자궁절제술 시행 받은 265명을 대상으로 하였다. 자궁 무게를 180 g 미만인 60명 (Group 1), 180 g 이상 350 g 미만인 141명 (Group 2), 350 g 이상인 64명 (Group 3)으로 나누어 비교하였다. 수술 후 의무기록을 이용하여 후향적 분석을 통해 자궁 무게에 따른 이환율의 상관관계를 알아보았다. 결과: 각 군간 나이, 분만력, 체질량 지수, 골반수술 병력, 내과적 병력에서는 각 군간의 유의한 차이는 없었다. 수술 중, 수술 후 합병증에서도 유의한 차이는 없었으나 자궁의 무게가 클수록 수술시간이 길었다. 결론: 복강경하 자궁절제술은 거대 자궁에서도 안정적으로 시행될 수 있으므로 단순히 자궁의 무게가 복강경하 자궁절제술 시행의 기준이 되어서는 안 된다.
Abstract
Objective: To evaluate the effect of uterine weight on short-term outcome of total laparoscopic hysterectomy (TLH) for benign gynecological conditions. Methods: A retrospective medical records review of 265 cases of patients with TLH was performed. Patients included in this study underwent TLH as benign uterine disorders at Kangnam Sacred Heart Hostpital, Hallym University from January 2008 through June 2009. These patients were stratified into three groups; Group 1 patients with uterus weighing less than 180 g (n=60), Group2 patients with uterus weighing 180 g to 350 g (n=141), Group 3 patients with uterus weighing more than 350 g (n=64). The groups were compared as regard postoperative stay, operative time, estimated blood loss, hemoglobin change, conversion to open surgery, and postoperative complications. Results: There was no significant difference in age, gravidity, body mass index, previous pelvic surgery and past medical history. The overall complication rates were not significantly different. But operative time prolonged as uterine weight increased. Conclusion: The TLH can be performed successfully in case of enlarged uterus. Therefore the enlarged uterus is not an absolute contraindication for TLH.
참고문헌 (20)
- Reich H, "Laparoscopic hysterectomy", J Gynecol Surg, 5, pp.213~216 (1989)
- Wattiez A, "The learning curve of total laparoscopic hysterectomy: Comparative analysis of 1647 cases", J Am Assoc Gynecol Laparosc, 9, pp.339~345 (2002)
- Reich H, "Laparoscopic hysterectomy", Baillieres Clin Obstet Gynaecol, 8, pp.799~815 (1994)
- Boike GM, "Laparoscopically assisted vaginal hysterectomy in a university hospital: Report of 82 cases and comparison with abdominal and vaginal hysterectomy", Am J Obstet Gynecol, 168(6), pp.1690~1697 (1993)
- Davies A, "Hysterectomy: Surgical route and complications", Eur J Obstet Gynecol Reprod Biol, 104, pp.148~151 (2002)
- Garry R, "The future of hysterectomy", BJOG, 112, pp.133~139 (2005)
- Kovac SR, "Guidelines for the selection of the route of hysterectomy: Application in a resident clinic population", Am J Obstet Gynecol, 187, pp.1521~1527 (2002)
- Bonilla DJ, "Uterine weight as a predictor of morbidity after a benign abdominal and total laparoscopic hysterectomy", J Reprod Med, 52, pp.490~498 (2007)
- Heinberg EM, "Total laparoscopic hysterectomy in obese versus nonobese patients", Obstet Gynecol, 103, pp.674~680 (2004)
- Olsson JH, "Cost effectiveness and health status after laparoscopic and abdominal hysterectomy", J Am Assoc Gynecol Laparosc, 3(4), pp.37~ (1996)
- Phillips G, "Techniques of partial hysterectomy: An overview", Zentralbl Gynakol, 117, pp.625~628 (1995)
- Munro MG, "Laparoscopic hysterectomy: Does it work?: A bicontinental review of the literature and clinical commentary", Clin Obstet Gynecol, 38, pp.401~25 (1995)
- 김연주, "Total Laparoscopic Hysterectomy (TLH):300예의 임상분석", Korean Journal of Obstetrics and Gynecology, 45(2), pp.13~13 (2002), 대한산부인과학회
- 박현정, "골반경하 전자궁적출술 (TLH)과 골반경하 질식 전자궁적출술 (LAVTH) 및 복식 전자궁적출술 (TAH)에 관한 임상적 고찰", Korean Journal of Obstetrics and Gynecology, 49(3), pp.644~652 (2006), 대한산부인과학회
- Feroze RM, "Vaginal hysterectomy and repair", Clin Obstet Gynaecol, 5, pp.545~556 (1978)
- Wattiez A, "Total laparoscopic hysterectomy for very enlarged uteri", J Am Assoc Gynecol Laparosc, 9, pp.125~130 (2002)
- Fiaccavento A, "Total laparoscopic hysterectomy in cases of very large uteri: A retrospective comparative study", J Minim Invasive Gynecol, 14, pp.559~563 (2007)
- Ng CC, "Total laparoscopic hysterectomy: A 5-year experience", Arch Gynecol Obstet, 276, pp.613~618 (2007)
- 백종우, "복강경하 전자궁적출술 (TLH)과 복식 전자궁적출술 (TAH)의 비교연구", Korean Journal of Obstetrics and Gynecology, 48(6), pp.1490~1496 (2005), 대한산부인과학회
- Walsh CA, "Total abdominal hysterectomy versus total laparoscopic hysterectomy for benign disease: A meta-analysis", Eur J Obstet Gynecol Reprod Biol, 144, pp.3~7 (2009)