Objective To compare the clinical efficacy between reformed laparoscopic-assisted vaginal hysterectomy with sutureless of cardinal and uterosacral ligament(LAVH)and trans abdominal hysterectomy(TAH)for large uterus.Methods A retrospective study was performed using 106 reformed LAVH patients(observation group)and 100 TAH patients(control group)whose uterus were big(≥ 12weeks of gestation),the information was observed in perioperative period.Results Anal exsufflation time,hospitalization time after operation and postoperative pain time in observation group[(25.4 ± 3.3)h,(6.5 ±1.5)d,(16.9 ± 2.4)h]were significantly shorter than those in control group[(42.4 ± 5.3)h,(8.5 ± 1.5)d,(30.6 ± 5.3)h](P ＜ 0.05),the rate of complication in observation group[5.7％(6/106)]waa lower than that in control group[10.0％(10/100)](P＜ 0.05).Conclusion As to large uterus,reformed LAVH has several advantages over TAH,the technique is easy to learn,operation time is short,and the rate of complication is low.

Objective To evaluate hernia repair with Onlay (premuscular positioning of the prosthesis) for the treatment of parastomal hernia.Methods In this study 45 patients with parastomal hernia were treated with a tension-free manner of hernia repair in situ by Onlay using prolene mesh between February 2006 and April 2012.There were 24 males and 21 female cases,including 6 recurrent parastomal hernia cases.The average age was (49 ±8) years ranging from 43 to 80.The parastomal defect ranged from 4 cm to 9 cm.Results All operations were successful.There was no hospital death or severe postoperative complications.The mean operating time was (109 ± 23) min (96-148),and the average time of pulling out the gastrointestinal decompression tube was (2.0 ± 2.0) day (12 h-3 d) and the drainage tube was removed after (5.0 ± 2.0) days (4-9 d).The mean postoperative hospitalization was (11 ± 3) days (9-16 d).42 cases achieved primary healing.The serofluid swelling in 7 cases was cured by puncturing and pressing the incision.41 cases were followed-up from 8 to 48 months,and 4 patients suffered from hernia recurrence respestively after 3 months,4 months,4.5 months and 7 months.One recurrent case was healed by conservative therapy and the other three were healed by reoperation.Conclusions Hernia repair in situ with Onlay method for parastomal hernia with prolene mesh was a safe and effective.