[Evaluation of clinical effect of hysterectomy preserving the uterine artery].

Objective: To discuss the clinical feasibility of hysterectomy that preserves the ascending branch and the ovarian branch of the uterine artery, and the effect on the ovary.

Methods: Fifty-two women who received hysterectomy with preservation of the ovaries, the so called divest due to benign gynecological disease were selected as the study group. It consisted of 35 patients who received subtotal-divest and 17 patients who received total-divest. Meanwhile, 38 cases who received traditional hysterectomy served as the control group. Two milliliter venous blood was taken and estradiol, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) were measured at 1 month preoperation, 1 month, 6 months, and 12 months postoperation from 30 women with age ranging from 36 - 45 years of the two groups each. All the patients in the study group received ultrasonography via vagina at 1 month preoperation and postoperation, respectively.

Results: Postoperatively, through vagina color ultrasound examination, in the 52 cases of study group, bilateral uterine arteries were not retained in 1 case, and unilateral uterine artery was not retained in 6 cases. The postoperative peak blood flow of uterine artery during systolic phase (Va) was (20 +/- 9) cm/s, and during diastolic phase (Vb) was (3.8 +/- 3.2) cm/s. Compared with the preoperative values, (29 +/- 8) cm/s, (7.1 +/- 3.4) cm/s, the velocity of blood was slowed obviously (P < 0.01). The postoperative resistance index (RI) (0.79 +/- 0.08), was not significantly different compared with the preoperative value (0.80 +/- 0.08) (P > 0.05). The operative time, bleeding volume, and the postoperative exhaust time had no significant difference between the two groups (P > 0.05). Comparing the hormone assay of two groups, there was a significant change at 6 months postoperation in the control group, but postoperation hormone assay had no significant change compared with the pre-operative result in study group. It indicated that the new approach did not affect the ovarian functions.

Conclusion: The divest is applicable in clinics, and it can preserve the completeness of blood-supply and the function of the ovary.