복강경하 질식 전자궁적출술 (LAVH) 570예에대한 임상적 고찰
A Clinical Study on 570 Cases of Laparoscopy Assisted Vaginal Hysterectomy (LAVH)
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목적 : 복강경하 질식 전자궁적출술을 시행받은 부인과 환자에 있어서 환자들의 특징과 임상 결과를 보고하여 그 효율성을 평가하기 위하여 후향성 연구를 시행하였다. 연구 방법 : 2001년 9월부터 2004년 2월까지 가천의과대학교 길병원 산부인과에서 골반경하 질식 전자궁적출술을 시행받은 570명의 환자를 대상으로 하였다. 평균 나이, 출산력, 체중, 이전 수술 기왕력, 수술 적응증, 수술 결과, 그리고 수술 합병증 등을 비교하였다. 결과 : 평균 나이는 46.4±7.2세였다. 평균 출산력은 2.4±1.4회였으며 평균 체중은 63.4±8.2 kg였다. 이전 수술 기왕력은 총 195회 (34.2%)였다. 수술의 적응증은 자궁근종 및 자궁선종이 총 75.1%로 가장 많았다. 평균 수술 시간은 72.3±20.6분이었으며 평균 재원일은 4.5±0.6일이었다. 주된 합병증은 투관침 부위 출혈, 방광 손상, 장손상, 요도 손상 등이었다. 결론 : 복강경하 질식 전자궁적출술은 안전하고 효율적인 수술술기로서 기존의 개복수술을 대체하여 부인과 질환에 더욱 폭넓게 사용할 수 있겠다.
Abstract
Objective : To evaluate the clinical outcome and characteristics of laparoscopy assisted vaginal hysterectomy (LAVH) in gynecologic patients. Methods : From September, 2001 to February, 2004, total 570 cases of patients were performed LAVH at Gacheon medical school Ghil Hospital. We reviewed medical records and analyzed these cases about age, parity, weight, previous surgery history, operation indication, operation outcome, duration of hospitalization and complication. Results : The results of this study summarized as follows. The mean age of patients was 46.4±7.2 years old. Average parity of patients was 2.4±1.4. Average weight of patients was 63.4±8.2 kg. Previous operation history was 195 cases (34.2%). Most common operation indication was uterine leiomyoma, followed by adenomyosis, combination of leiomyoma and adenomyosis and endometriosis. The mean operation time was 72±20.6 minutes. The mean duration of hospitalization was 4.5±0.6 days. The major complication of operation was trocar site bleeding, followed by bladder injury, bowel injury, and ureteral injury. Conclusion : LAVH is safe and useful. So it is recommendable to gynecologic patients.
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