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子宫切除术是最常见的妇科手术。传统的经腹全子宫切除术(total abdominal hysterectomy,TAH)适用于所有子宫切除,早已为妇科医师所熟悉。经阴道全子宫切除术(totalvaginal hysterectomy,TVH)以往用于治疗子宫脱垂患者,近年来因该术式符合微创的原则,又重新受到重视,但具有手术野窄、手术难度较大、对技术要求较高等局限。随着腹腔镜技术的发展,腹腔镜辅助阴式全子宫切除术(Iaparocopic assistedvaginal hysterectomy,LAVH)越来越多地应用于临床,该术式既符合微创的原则,又可清楚了解盆腔情况,在很大程度上提高了阴式手术的安全性和可操作性。究竟何种术式是子宫切除的理想术式,TVH和LAVH能否在所有的患者中完全替代TAH,值得探讨。
Hysterectomy is the most common gynecological surgery. Traditional total abdominal hysterectomy (TAH) for all hysterectomy, has long been familiar to the gynecologist. Transvaginal total hysterectomy (totalvaginal hysterectomy, TVH) in the past for the treatment of uterine prolapse patients, in recent years due to the operation in line with the principle of minimally invasive, and re-attention, but with a narrow surgical field, the operation more difficult, Higher technical requirements and other limitations. With the development of laparoscopy, laparoscopic assisted vaginal hysterectomy (LAVH) is increasingly used in clinical practice, which is not only consistent with the principle of minimally invasive, but also a clear understanding of pelvic conditions, To a large extent, improve the safety and operability of the vaginal surgery. What kind of surgery is the ideal surgical hysterectomy, TVH and LAVH in all patients can completely replace TAH, it is worth exploring.