再谈腹腔镜下子宫次全切除还是全切SubtotalHysterectomyor.PDF

再谈腹腔镜下子宫次全切除还是全切 Subtotal Hysterectomy or Hysterectomy 西安交通大学医学院第二附属医院妇产科 Department of Obstetrics and Gynecology, Second Affiliated Hospital of Xian Jiaotong University 薛 翔 Xue Xiang 子宫切除术发展史 History of Hysterectomy 阴式子宫切除 Vaginal hysterectomy 追溯到: Themison (Athens) 50 BC Soranus (Ephesus): 120 AD 存在问题: 当时应急性, 术后死亡率高, 漏尿, 病人痛苦。 Problems: hig mortality rate, leakage of urine, pain 子宫切除术发展史 History of Hysterectomy 阴式子宫切除 Vaginal hysterectomy Conrad Langenbeck, 1813 年, 德国, 首次报道成功开展了经阴道子宫切除 , 尸检证实。 First success reported (confirmed by autopsy): Conrad Langenbeck, 1813, Germany 子宫切除术发展史 History of Hysterectomy 经腹子宫切除 Abdominal hysterectomy Walter Burnham, 1853 年, 美国lowell,massachusetts,随后13 年15 例手 , 仅3 个病人活着, 其余病人死于 败血症, 腹膜炎和出血。 Walter Burnham (Lowell, Massachusetts, USA) performed 15 operations within 13 years from 1853. Only three patients survived, while the others died of sepsis, peritonitis or hemorrhage. Gilman Kimball, 同年, 在同一座城市, 完成了经腹子宫切除 , 包括次全子宫切除术。 Also in 1853, Gilman Kimball, in the same city, completed the abdominal hysterectomy, including subtotal hysterectomy. 子宫切除术发展史 History of Hysterectomy 随着抗菌素的出现和止血手段的成熟, 子宫切除手术安全性增加, 子宫切除手术例数急剧增加。在妇产科手 数量跃居第二, 仅次于剖宫产。 The emergence of antimicrobial and the maturing of hemostatic means improve the safety of hysterectomy, and the number of hysterectomy cases has increased dramatically, only second to the number of cesarean cases among obstetrics and gynecology operations. 子宫切除术发展史 History of Hysterectomy 据文献报道: 美国每年