단일공법 복강경하 질식자궁절제술 110예의 고찰 및 다공법과의 비교 = Evaluation of 110 cases of single-port access Laparoscopically assisted vaginal hysterectomy (SPA-LAVH) and comparison with multi-port access

다국어 초록 (Multilingual Abstract)

Objective: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). Methods: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary`s Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim`s Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. Results: There was no significant difference in patients` age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients` mean age was 46.1±7.0 years (SPA-LAVH) and 45.5±6.3 years (MPA-LAVH). The mean operating time was 87.2±21.0 minutes (SPA-LAVH) and 83.3±20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4±139.7 g (SPA-LAVH) and 257.8±132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1±0.7 g/dL (SPA-LAVH) and 1.2±0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6±0.6 days [SPA-LAVH] and 3.3±0.7 days [MPA-LAVH], P<0.05). Conclusion: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.