在机器人辅助全腹腔镜切除子宫术后,阴道袖口消声的危险因素:一项回顾性队列研究
Silje Eilertsen Denstad1,2, Ingrid Volløyhaug1,2, Marit Lieng3,4
1Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Acta obstetricia et gynecologica Scandinavica
|January 21, 2026
概括
在机器人辅助整体子宫切除术 (RA-TLH) 后,阴道袖口脱声 (VCD) 影响了4.2%的女性. 更高的BMI可以防止VCD,而更大的子宫会增加风险,强调需要个性化手术前咨询.
科学领域:
- 妇科外科手术 妇科外科
- 最少侵入性手术的方法
- 手术并发症 手术并发症
背景情况:
- 最少侵入性手术 (MIS) 与腹腔切除术相比,具有优势,包括更短的住院时间和更快的恢复.
- 机器人辅助整体子宫切除术 (RA-TH) 越来越多地使用,但与更高的阴道袖子脱声 (VCD) 风险有关.
- 在RA-TH后识别VCD的风险因素对于患者安全和知情同意至关重要.
研究的目的:
- 确定与机器人辅助整体子宫切除术 (RA-TH) 后阴道袖口消声 (VCD) 相关的患者相关和手术风险因素.
主要方法:
- 2010年至2021年期间接受RA-TH的妇女的医疗记录的回顾性审查.
- 具有和没有VCD的女性之间的人口和手术数据的比较.
- 单变量和多变量逻辑回归分析以确定VCD的风险因素.
主要成果:
- 在4.2%的患者中发生了阴道袖口脱声 (VCD),阴道性交是最常见的触发因素.
- 单变量分析表明年龄较小,BMI较低,手术持续时间较长,子宫体重较高与VCD风险增加有关.
- 多变量分析显示,增加的BMI (aOR 0.87) 降低了VCD的几率,而增加的子宫体重 (aOR 1.30) 提高了VCD的几率.
结论:
- 阴道袖口脱声 (VCD) 是机器人辅助全子宫切除术 (RA-TH) 后的一个重大并发症,发生在4.2%的病例中.
- 较高的身体质量指数 (BMI) 似乎可以保护VCD,而较大的子宫则会增加风险.
- 术前咨询应解决个体风险因素和手术方法的优点/缺点.
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