Abdominal trauma ossification complicated with Incisional hernia and esophageal hiatal hernia: A case report and literature review

Abstract

Objective To evaluate the clinical effect of the improved laparoscopic assisted vaginal hysterectomy for the removal of huge uterine and to explore its value and significance. Methods The clinical data of 180 patients undergoing laparoscopic assisted vaginal hysterectomy were analyzed retrospectively. Average age(49.4±8.5) years old. All patients were divided into observation group (uterine ≥ 12 weeks) and control group (uterus< 12 weeks). Indicators were compared with the two groups of cases of general information, operation time, blood loss, blood transfusion rate, average hospitalization days, incidence of complications, and conversion rate. Results There were no statistically significant differences between the two groups in terms of age and BMI. The uterine size of the observation group was larger than that of the control group[(15.4±3.6)weeks vs (7.6±2.2)weeks], and there were also differences in disease constitute between two groups (P<0.001). In the observation group, the average operation time[(83.9±32.9)min vs (50.6±20.8)min(P<0.001)], intraoperative blood loss[(259.4±122.6)ml vs (150.9±95.1)ml (P<0.001)] and blood transfusion rate[8(10.3%)vs 2(2.0%)(P=0.016)] were more than those in the control group, the difference was statistically significant. There was no significant difference between the two groups in the incidence of surgical complications, the average hospitalization days and the rate of conversion to laparotomy. Conclusions The improved laparoscopic assisted vaginal hysterectomy for the removal of the uterus is safe and reliable. Although the amount of intraoperative bleeding and operation time in the observation group was higher than the control group, but the incidence of surgical complications and the average hospitalization days did not increase. Following strict operation indications and operation technique are the keys to get the best result. Key words: Laparoscopic assisted vaginal hysterectomy; Improved operation method; Large uterine; Complication