Objective To investigate the effect of laparoscopic hysterectomy and open hysterectomy on ovarian hemodynamics.Methods Selected 132 patients who underwent hysterectomy,among them,76 cases (laparoscopic group)underwent laparoscopic hysterectomy,56 cases(open group)underwent open hysterectomy.The preoperative and postoperative ovarian artery hemodynamic parameters,T cell subsets and serum hormone index of the two groups were observed.Results In the observation group and the control group postoperative 48h,the pulsatility index(PI), resistance index (RI),systolic blood flow velocity maximum (Vmax)and diastolic stage blood velocity minimum (Vmin)decreased(all P <0.05),which of postoperative 2 weeks increased(all P <0.05).The RI,Vmax and PI in the observation group postoperative 48h and 2 weeks were (1.17 ±0.16)and (1.30 ±0.14),(0.66 ±0.11)and (0.70 ±0.06),(11.80 ±3.10)m/s and (12.17 ±3.26)m/s,(3.01 ±0.19)m/s and (2.98 ±0.20)m/s,which were all higher than those in the control group(t =-10.637 and -7.609,-5.880 and -2.583,-5.084 and -3.271,-13.660 and -4.826,all P <0.05).The CD +4 and CD +3 T cells levels of the observation group and control group postoperation were increased(all P <0.05),and the CD +8 T cells levels were decreased(all P <0.05).The CD +4 and CD +3 T cells levels of the observation group postoperative 48h and 2 weeks were (43.50 ±3.50)% and (47.20 ±3.16)%, (73.50 ±6.17)% and (80.06 ±9.20)%,which were higher than those in the control group(t =-6.859 and -5.599,-5.515 and -4.853,all P <0.05),while the CD +8 T cells were (37.52 ±5.10)% and (34.10 ±3.20)%,which were lower than those in the control group(t =3.007 and 3.214,all P <0.05 ).The estradiol(E2 )levels of the observation group and control group were significantly decreased(all P <0.05),follicle stimulating hormone(FSH) levels were significantly increased(all P <0.05).The E2 levels of the observation group postoperative 1 month and 3 months were significantly lower than those of the control group(all P <0.05),FSH levels were significantly higher than those of the control group (P <0.05).Conclusion The effect of laparoscopic hysterectomy on ovarian hemodynamics, ovarian function and immune function is small,and it is worth to be popularized in clinical application.

Objective:Laparoscopic surgery for cervical cancer has the advantages of little blood loss and rapid recovery,but its therapeutic effect is still controversial.This study aims to analyze the surgical procedure and clinical efficacy of tumor-free laparoscopic radical hysterectomy without a uterine manipulator for early-stage cervical cancer,and to explore the indications of laparoscopic surgery for cervical cancer. Methods:This study was a retrospective study.The data of patients who underwent radical hysterectomy for early-stage cervical cancer admitted to Hunan Provincial Maternal and Child Health Care Hospital from July 2019 to December 2021 were collected.According to 2018 the International Federation of Gynecology and Obstetrics(FIGO)clinical staging,all patients were in IA1 with lymphovascular invasion,IA2,and IB1 stage.Among them,45 patients underwent tumor-free laparoscopic radical hysterectomy without a uterine manipulator(laparoscopy group)and 16 patients underwent open surgery(open surgery group).Patients were followed up for 12-41 months.The differences between the 2 groups in terms of operative time,bleeding volume,extent of surgical resection,surgical complications,and prognosis were compared and analyzed. Results:Compared to the open surgery group,the laparoscopy group had significantly shorter operation time and less intraoperative blood loss(both P＜0.001).There were no significant differences between the 2 groups in terms of the length of excised uterosacral ligaments,cardinal ligaments,vagina,and the number of excised lymph nodes(all P＞0.05).The incidence of postoperative complications did not differ significantly between the groups(P＞0.05).No death or recurrence occurred in the 2 groups during the follow-up period.The overall survival rate and disease-free survival rate were both 100%. Conclusion:For early-stage cervical cancer with a diameter≤2 cm,tumor-free laparoscopic radical hysterectomy without a uterine manipulator is safe and feasible,and the short-term outcomes is no less than that of open surgery.