Reformed laparoscopy-assisted vaginal hysterectomy for treatment of big myoma

Objective: To compare the clinical results of modified laparoscopy-assisted vaginal hysterectomy(LAVH) and through vaginal hysterectomy(TVH) in treatment of big myoma(≥ 12 gestation weeks).Methods: The clinical data of cases with big myoma who had undergone uterus hysterectomy in 2008 in the First People's Hospital of Shanghai were collected.Thirty-six cases were treated by LAVH and 36 cases by TVH.The operation time,blood loss in the operation,body temperature and passage of gas by anus after the operation were analyzed and compared between the two groups.Results: The operation time and bleeding in the operation were decreased obviously in the modified LAVH group compared with those in the TVH group(P<0.01).But the body temperature and passage of gas by anus after operation were not statistically different between the two groups(P>0.05).In TVH group,rectum injury was observed in 1 case,which was mended by cutting the abdomen operation,and vaginal stump bleeding was noted in 2 cases,which was managed after reexamination through the vagina.The operation was all successful in the modified LAVH group and no complication occurred.Conclusions: Reformed LAVH makes the operation less difficult and shortens the operation time,which promises a wide prospect in the basal hospitals.