目的:研究各种子宫切除术技术,以确定其对患者预后的影响,包括疼痛程度,性功能,焦虑,和生活质量。特别关注的是血管密封和传统的腹部缝合之间的比较,阴道,和腹腔镜子宫切除术.本研究在综合评价方面独具特色,考虑到患者满意度,推荐率,恢复时间,和其他各个方面。
方法:我们的前瞻性队列研究遵循伦理指南,包括对患者的细致评估,包括病史,焦虑程度,盆腔疼痛,性功能,和生活质量。向患者解释了手术方法,让他们积极参与决策过程。收集了社会人口统计信息,并应用排除标准.子宫切除方法包括经腹子宫全切术(TAH),腹腔镜子宫切除术(TLH),阴式子宫切除术(VH),以及一种名为VHMujas的改良阴道技术。记录了几个参数,包括操作指示,子宫体积,住院,操作持续时间,术前和术后并发症,还有更多.
结果:在所有组中,术前-术后FSFI性功能值增加有统计学意义(p<0.001).决定进行阴道手术后,患者的基础贝克焦虑量表评分显着下降,VH和VHMujas组(p<0.05)。然而,在决定进行腹部和腹腔镜手术后,患者初始评估时的贝克焦虑量表评分显着增加(p<0.001)。根据SF-36生活质量评估结果,在因VH而接受不同方法手术的患者中,所有术后生活质量参数均升高(p<0.05).
结论:我们对子宫切除术技术的综合比较表明VH,特别是在使用Mujas技术时,在患者安全和术后满意度方面优于其他子宫切除术方法,但也具有最小的侵入性。值得注意的是,这反映在生活质量的提高上,增强性功能,较低的疼痛评分,和良好的美容效果。子宫切除术的成功取决于精确的适应症,手术计划,适当的病人选择,和有效的沟通。本研究强调了这些因素在实现最佳结果方面的重要性。开发专门的血管闭合装置可以进一步提高阴式子宫切除术的可行性,使其成为妇科手术的首选。该研究为选择最适合患者的子宫切除术方法和优化患者的康复提供了有价值的见解。
OBJECTIVE: To investigate diverse hysterectomy techniques to determine their influence on patient outcomes, including pain levels, sexual function, anxiety, and quality of life. Of particular focus is the comparison between vessel sealing and traditional suturing in abdominal, vaginal, and laparoscopic hysterectomies. This study is unique in its comprehensive evaluation, considering patient satisfaction, recommendation rates, recovery times, and various other aspects.
METHODS: Our prospective cohort study adhered to ethical guidelines, involving a meticulous assessment of patients, including medical history, anxiety levels, pelvic pain, sexual function, and quality of life. Surgical methods were explained to patients, allowing them to actively participate in the decision-making process. Sociodemographic information was collected, and exclusion criteria were applied. Hysterectomy methods included total abdominal hysterectomy (TAH), laparoscopic hysterectomy (TLH), vaginal hysterectomy (VH), and a modified vaginal technique known as VH Mujas. Several parameters were recorded, including operation indications, uterine volume, hospital stay, operation duration, pre-operative and post-operative complications, and more.
RESULTS: In all groups, a statistically significant increase was found in pre-operative-post-operative FSFI sexual function values (p < 0.001). The patient\'s basal Beck Anxiety Scale scores significantly decreased following the decision for vaginal surgery, both in the VH and VH Mujas groups (p < 0.05). However, Beck Anxiety Scale scores at patients\' initial assessments significantly increased following the decision for abdominal and laparoscopic surgery (p < 0.001). According to the results of the SF-36 quality of life assessment, an increase was observed in all post-operative quality of life parameters in patients who underwent surgery with different methods due to VH (p < 0.05).
CONCLUSIONS: Our comprehensive comparison of hysterectomy techniques demonstrated that VH, particularly when utilizing the Mujas technique, outperforms other hysterectomy methods regarding patient safety and post-operative satisfaction but also offers the benefit of minimal invasiveness. Notably, this is reflected in improved quality of life, enhanced sexual function, lower pain scores, and favorable cosmetic results. The success of a hysterectomy procedure depends on precise indications, surgical planning, proper patient selection, and effective communication. This study emphasizes the significance of these factors in achieving optimal outcomes. The development of specialized vascular closure devices can further enhance the feasibility of vaginal hysterectomy, making it a preferable choice in gynecological surgery. The study contributes valuable insights into selecting the most suitable hysterectomy method for patients and optimizing their recovery.