الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
 |  | from | 147 |  |  |
| | | from | 147 | | |
Abstract
The hysterectomies can be performed with traditional total, subtotal, intrafascial, vaginal or laparoscopic approach. Total abdominal hysterectomy is the standard of care today.
In the vast majority of the hysterectomies performed, there is no need for removal of the cervix, however, total hysterectomy is performed as standard of care for the prevention of future cervical cancer and menstrual bleeding. Subtotal Hysterectomy is mostly performed for difficult surgical cases and is criticized for future risk of carcinoma of cervical stump and cost of its preventive care.
For removal of cervical canal and T-Zone, many physicians have tried intrafacial hysterectomy or performed supracervical hysterectomy and tried to destroy the cervical canal using electrocautery needle or cone biopsy electrode. However the procedures are never uniform and results are variable.
Total hysterectomy continued to be the standard of care for benign medical conditions. Total hysterectomy has increased risk for ureter injury, longer recovery period, and increased risk for vaginal cuff hematoma, abscess, distortion and prolapse. The supracervical hysterectomy has shorter recovery time, reduced or no risk for ureter injuries. However, supracervical hysterectomy has increased risk of future cervical dysplasia, cancer, cervicitis, and menstrual bleeding.
The aim of this study is to compare conventional subtotal hysterectomy and sutuerless subtotal hysterectomy with LigaSure and endocervical resection .
The study included 30 patients scheduled for hysterecctomy with different gynecologic complaints. Preoperative and intraoperative data were collected and statistically analyzed.
In the current study the mean of age were 56.9±6.11 and 57.2±8.01 years for group I and II respectively. There were no statistical significant differences between the two studied groups regarding age.
There was no significant difference between the two studied groups regarding parit, previous pelvic surgery and body mass index.
There was a highly significant increase in operative time in group II (45-60 minutes) than group I (10-15 min).
The most common indication was perimenopausal bleeding and postmenopausal bleeding which was represented by 46.4%, while fibroid uterus was the second indication which was represented by 40%.
There was a highly significant increase in length of hospital stay (days) in group II (2-4 days) than group I (1-2 days).
In our study, there was a highly significant increase in amount of blood loss (ml) in group II (150-350) than group I (100-250).
In our study, there was a significant increase in vaginal bleeding in group II (pyrexia, wound infection, wound haemetomy, re-hospitalization and vaginal bleeding) than group I.
Conclusion and recommendations
• Subtotal hysterectomy “SH” with Endo- cervical resection “ER” is : A Simple, Safe and Fast procedure.
• It prserves all the pelvic supports , the pelvic neural plexus and hence the sexual & urological functions.
• It eliminates the potential risk of cancer cx.
• However, a bigger number and longer follow up periods are mandatory for fair assessment.