title: [Four surgical patterns of hysterectomy for uterine without prolapsis: a clinical study].
abstract: OBJECTIVE
  To evaluate the clinical effects of the four surgical patterns of hysterectomy for uterine without prolapsis.
  
  
  METHODS
  Six hundred and eight patients with different gynecological diseases were operated upon by transvaginal hysterectomy (TVH, 78 cases), laparoscopically assisted vaginal hysterectomy (LAVH, 102 cases), classical intrafascial supracervical hysterectomy (CISH, 228 cases), or transabdominal hysterectomy (TAH, 200 cases). The clinical effects of these surgical patterns were analyzed.
  
  
  RESULTS
  The success rate was 100% for TVH, 99.1% for CISH, and 98.0% for LAVH. The bleeding time and bleeding amount were significantly shorter or less in the TVH group than in the other 3 groups (P < 0.05), without a significant difference among the 3 groups. The percentage of analgesic use and postoperative morbidity were significantly higher in the TAH group than in the other 3 groups (P < 0.01), without a significant difference among the 3 groups. The days of hospitalization in the TAH group were significantly more than those in the other 3 groups (P < 0.05), without a significant difference among the 3 groups. The hospitalization expense was greater in the LAVH and CISH groups than in the TVH and TAH groups Except 2 cases of damages to the supravesical artery or ureter occurring during the early stage of CISH group, no surgical damage was found.
  
  
  CONCLUSIONS
  Highly effective and with less injury, minimally invasive surgery in hysterectomy is worth spreading. LAVH and CISH apply in the cases with severe pelvic adhesion, with adhesive adnexa to be resected, or with adnexal cyst > 5 cm. CISH and TAH apply in the uterine larger than 16 weeks pregnant size. LAVH and TAH apply in the cases highly suspected as malignant diseases of uterine or endometrium.
authors.affiliation: Gynecological and Obstetrical Hospital, Fadan University, Shanghai 200011, China.
authors.forename: Keqin
authors.initials: K
authors.lastname: Hua
authors.forename: Jinfang
authors.initials: J
authors.lastname: Lin
authors.forename: Xishi
authors.initials: X
authors.lastname: Liu
authors.forename: Weiwei
authors.initials: W
authors.lastname: Feng
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.forename: Fang
authors.initials: F
authors.lastname: Fang
authors.forename: Changdong
authors.initials: C
authors.lastname: Hu
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Zhang
authors.forename: Chang'en
authors.initials: C
authors.lastname: Xu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy; D008875:Middle Aged; D011247:Pregnancy; D011391:Prolapse; D014594:Uterine Neoplasms / Q000601:surgery; D014599:Uterus / Q000601:surgery*