中国实用妇科与产科杂志2018，Vol.34Issue(5)：542-546,5.DOI:10.19538/j.fk2018050116
高龄肥胖女性腹腔镜手术和开腹手术疗效比较
Comparison of gynecological laparoscopic surgery with laparotomy for the elderly obese women
王岳萍 1龙雯晴 1刘华 1冯炜炜 1沈立翡1
作者信息
- 1. 上海交通大学医学院附属瑞金医院妇科,上海 200025
- 折叠
摘要
Abstract
Objective To evaluate the efficacy and safety of gynecological laparoscopic surgery in elderly obese women. Methods We retrospectively analyzed 230 cases of elderly obese(Body Mass Index,BMI＞25.0)patients over 70 years old from January 2009 to June 2017 in Ruijin Hospital,School of Medicine,Shanghai Jiao Tong University.Among them 122 cases received laparoscopic surgeries,whereas 108 cases underwent laparotomies. The ASA classifications, preoperative complications,BMI index,surgical methods,postoperative diagnosis results and complications were recorded and analyzed statistically.Results There were no significant differences in age,ASA classifications or BMI index between the two groups. More patients with cardiac disease or moderate to severe pulmonary ventilation dysfunction underwent laparotomy. Laparoscopic hysterectomy was superior to laparotomy surgery in surgical time[(57.26±7.68)min vs.(87.10±10.70)min,P＜0.05],bleeding[(55.27±26.67)mL vs.(105.34±73.03)mL,P＜ 0.05],anal evacuation[(1.34±0.48)d vs.(2.29±0.75)d,P＜0.05]and length of hospital stay[(10.29±3.75)d vs. (14.18±5.44)d,P＜0.05].Laparoscopic radical surgery also took less surgical time[(167.69±19.64)min vs.(224.21± 33.88)min,P＜0.05]and had less bleeding[(193.07±117.50)mL vs.(351.58±261.71)mL,P＜0.05]than laparotomy surgery.Laparoscopic surgery had a greater advantage of reducing peri-operative bleeding in the Ⅱ obese women.The postoperative complications of laparoscopic surgery were fewer than those of laparotomy and vaginal surgery. Laparoscopic surgery was suitable for large ovarian cyst.Conclusion Laparoscopy is a safe and effective treatment for elderly obese patients with benign and malignant gynecologic diseases.关键词
腹腔镜/高龄/肥胖/妇科肿瘤Key words
laparoscopy/elderly/obese/gynecologic neoplasm分类
医药卫生引用本文复制引用
王岳萍,龙雯晴,刘华,冯炜炜,沈立翡..高龄肥胖女性腹腔镜手术和开腹手术疗效比较[J].中国实用妇科与产科杂志,2018,34(5):542-546,5.
