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دراسة اختلاطات استئصال الرحم بالطرائق المختلفة
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الهدف: أجريت هذه الدراسة المستقبلية لتحليل الاختلاطات خلال الجراحة و بعدها بين استئصال الرحم عن طريق البطن و استئصال الرحم عن طريق المهبل. مواد و طرق البحث: شملت الدراسة 120 مريضة (85 مريضة خضعن لاستئصال بطني و 35 مريضة خضعن لاستئصال رحم مهبلي ) و ذلك بقسم النسائية في مشفى الأسد الجامعي في اللاذقية في الفترة بين 1/7/2013 و 1/7/2014 . النتائج: كان معدل فترة العمل الجراحي في مجموعة الاستئصال البطني 103 دقيقة مقارنة مع 91 دقيقة في مجموعة الاستئصال المهبلي p=0,0192)). كانت أخماج الشق الجراحي أشيع سبب لارتفاع الحرارة بعد العمل الجراحي في مجموعة الاستئصال البطني بينما كانت الأخماج البولية أشيع سبب لذلك في مجموعة الاستئصال المهبلي. كان هناك 3 (3,5%) حالات لإصابة المثانة و حالتين (2,8%) لإصابات الحالب في مجموعة الاستئصال البطني بينما لم تسجل حالات لإصابة المثانة أو الحالب في مجموعة الاستئصال المهبلي. كانت هناك 3 (3,5%) حالات لنزف ثانوي بعد الجراحة في مجموعة الاستئصال البطني بينما سجلت حالة واحدة (2,8%) في مجموعة الاستئصال المهبلي. كان هناك 8 (9,4%) حالات من انسداد الأمعاء الشللي في مجموعة الاستئصال البطني بينما لم تجل أي حالة في مجموعة الاستئصال المهبلي . أما مجمل الاختلاطات فكانت 45 (52,9%) حالة في مجموعة الاستئصال البطني مقارنة مع 12 (34,2%) حالة في مجموعة الاستئصال المهبلي ((p=0,029.الاستنتاج : أظهرت هذه الدراسة أن استئصال الرحم عن طريق المهبل يترافق مع اختلاطات أقل خلال و بعد الجراحة مقارنة مع استئصال الرحم عن طريق البطن.
Objectives: This was a prospective study, conducted to analyze the intraoperative and postoperative complications between abdominal and vaginal hysterectomy. METHODS: This study was carried out on 120 patients (85 cases abdominal and 35 cases vaginal hysterectomy),in the department of gynecology at Al-Assad university hospital in Lattakia in the period between 1/7/2013-1/7/2014. Results: the mean duration of surgery of abdominal hysterectomy was 103 min and that of vaginal was 91 min (p=0.0192). Wound infection was the main cause for febrile morbidity in abdominal hysterectomy group where as urinary tract infection was the main cause for febrile morbidity in vaginal hysterectomy. There was 3)3,5%(case of bladder injury and 2(2,8%) case of ureteric injury in abdominal hysterectomy group while none in vaginal hysterectomy group Postoperatively there was 3 (3,5%) cases of secondary haemorrage in TAH group while 1(2,8%) case in vaginal hysterectomy .there were 8 (9,4%) cases of paralytic ileus in abdominal hysterectomy while none in vaginal hysterectomy . Overall 45 (52.9%) cases of abdominal hysterectomy and 12 (34.2%) case of vaginal hysterectomy had complications (p=0.029). Conclusions: This study showed that vaginal hysterectomy was associated with less intraoperative complications and postoperative complications as compared to abdominal hysterectomy.
References used
Eric V, M. operative gynecology. illustrated chapter forty two , London,1988, p:459-481
International Journal of Gynecology & Obstetrics. Volume 53, Issue 1, April 1996, Pages 65–72
Martin P, et all : the epidermiology of hysterectomy findings in large cohor study . Br .j . of obstet – Gyanecol 2008 vol 99,p :402-407
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