Surgical Blood Loss and Laparoscopic-Assisted Vaginal Hysterectomy (original) (raw)
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JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
We compared the perioperative morbidity of laparoscopic hysterectomy for gynecologic oncologic (group A) and benign gynecologic (group B) indications at a single institution. This is a retrospective analysis of 159 consecutive cases of laparoscopic hysterectomy at a tertiary care university hospital. It includes 74 women with gynecologic cancers and 85 women with benign gynecologic conditions. Patients in group A were significantly older and had higher body mass index (P < or = 0.001). The differences in mean blood loss (A, 201.1 mL; B, 183.6 mL, P=0.504), conversion to laparotomy (2 for each group), and wound infection (none) were not significant in the 2 groups. The mean operating time (253.2 and 188.2 minutes, P<0.001) and the mean length of hospital stay (3.5 days and 2.5 days, P<0.001) were significantly longer in group A. Transfusion was required for 2 patients in group A and 4 in group B. One intraoperative injury to the bladder occurred in group A. In spite of older...
Bleeding Associated with Vaginal Hysterectomy
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1997
considered as a risk factor for transfusion. In the gynaecology unit at Fairfield Hospital, hysterectomies were mostly performed by registrars, usually under the supervision of a consultant gynaecologist. These limitations notwithstanding, it is important for all obstetric and gynaecological units to review their own experience regarding blood use for surgical procedures so as to develop their own guidelines for transfusion practice. The identification of risk factors associated with transfusion allows refinement of preoperative cross-match ordering and predeposit programmes so that blwd can be utilized in a more efficient manner.
Trends and patterns in total laparoscopic hysterectomy in tertiary care hospital
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Patients with some degree of prolapse usually are suitable candidates to undergo vaginal and Laparoscopic assisted vaginal hysterectomy. Due to technical advances in this field there has been an increase in total laparoscopic hysterectomies all over the world in last decade. When compared with abdominal hysterectomy (AH) and Laparoscopic assisted vaginal hysterectomy (LAVH), Total Laparoscopic Hysterectomy (TLH) is associated with lesser blood loss, and shorter hospital stay, speedy postoperative recovery. 1-5
Abdominal, vaginal and total laparoscopic hysterectomy: perioperative morbidity
Archives of Gynecology and Obstetrics, 2011
PURPOSE: The aim of our retrospective study was to assess and to compare the surgical complications of hysterectomy regarding the choice of procedure [abdominal (AH), vaginal (VH), and total laparoscopic hysterectomy (TLH)].METHODS: A total of 6,480 patient charts undergone hysterectomy were retrospectively analyzed. Data including transfusion, bladder, ureteral and bowel injury, cuff dehiscence, pulmoner embolus, febrile morbidity, hematoma, reoperation, pelvic wall problems were gathered. The Chi-square test and Student's t test were used in the statistical analysis.RESULTS: The most common perioperative complication was blood transfusion which occurred in 114 patients (2.6%). VH patients required significantly less blood transfusion than AH (2.1, 2.6%, respectively). AH had significantly more bladder injury than VH (0.7, 0.4%, respectively). AH had significantly more ureteral injury than VH (0.2, 0.1%, respectively). AH had the same bowel injury as VH (0.1%). AH and VH necessitated significantly more reoperation than TLH (0.4, 0.2, 0.0%, respectively).CONCLUSION: To our study, VH ensures less complication rates than AH. In experienced centers, VH can be a reliable alternative to AH. Controlled prospective studies with large patient volumes are required to compare TLH and VH according to complication rates.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
Background: Vaginal hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim was to compare the risks and complications of laparoscopy assisted vaginal hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.Methods: A retrospective observational study was conducted in the Gynaecology ward at Vinakaya Mission’s Kirupananda Variyar Medical College and Hospitals, Salem, Tamil Nadu, India. The data for the past 1-year record was taken for analysis. A total of 80 subjects were included in the study and were divided into two groups with 40 patients under TAH (total abdominal hysterectomy) group and 40 under LAVH (Laproscopic assisted vaginal hysterectomy) group. The primary outcome of the present analysis was incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy,...
Minimally Invasive Surgery, 2014
Background.The idea of laparoscopic assisted vaginal hysterectomy (LAVH) is to convert a potential abdominal hysterectomy to a vaginal one, thus decreasing associated morbidity and hastening recovery. We compared intraoperative and postoperative outcomes between LAVH and abdominal hysterectomy, to find out if LAVH achieves better clinical results compared with abdominal hysterectomy.Material and methods.A total of 48 women were enrolled in the study. Finally 17 patients underwent LAVH (cases) and 20 underwent abdominal hysterectomy (controls). All surgeries were performed by a set of gynecologists with more or less same level of surgical experience and expertise.Results.None of the patients in LAVH required conversion to laparotomy. Mean operating time was 30 minutes longer in LAVH group as compared to abdominal hysterectomy group (167.06+31.97 min versus 135.25+31.72 min;P<0.05). However, the mean blood loss in LAVH was 100 mL lesser than that in abdominal hysterectomy and the d...
2017
Objective: To find out the intraoperative and postoperative complications associated with Laparoscopic assisted vaginal hysterectomy and Non descent vaginal hysterectomy. Design: Prospective observational study. Methods: A prospective observational study was undertaken in patients undergoing Laparoscopic assisted vaginal hysterectomy and Non descent vaginal hysterectomy in patients with benign gynecological pathology. Results: Operating time was lesser in Non descent vaginal hysterectomy group. Operating time was (87.36+/16.32 minutes in Laparoscopic assisted vaginal hysterectomy and 67.38+/-16.77 minutes in Non descent vaginal hysterectomy p-value =0.001). Intraoperative blood loss was significantly less in Non descent vaginal hysterectomy group (269.85+/-103.85ml in Laparoscopic assisted vaginal hysterectomy group and 219.05+/-84.37 ml in Non descent vaginal hysterectomy group p-value =0.026). Postoperative pain was also less in women undergoing Non descent vaginal hysterectomy gr...
Analysis of Total Laparoscopic Hysterectomy Operations Performed in Our Clinic
Objective: The purpose of this study was to evaluate the results of our experience with 83 patients who underwent total laparoscopic hysterectomy (TLH). Methods: The subjects included 83 patients operated in Gaziosmanpaşa Taksim Training and Research Hospital, Department of Obstetrics and Gynecology. Total laparoscopic hysterectomies were performed for various indications between January 2013 and October 2014. Indications of total laparoscopic hysterectomy, method of operation, intraoperative and postoperative complications, duration of the operation, length of hospital stay, and blood loss in patients who underwent total laparoscopic hysterectomies were retrospectively evaluated. Results: In total, 83 patients were included in our study. The mean age was 49.3 years. The most common indication for total laparoscopic hysterectomy was menorrhagia. The mean body mass index (BMI) was 28.7±4.3. The mean operation time was 132.16±48.5 min, mean hospital stay was 3.38±1.6 days, and mean blood loss was 2 g/dL. The overall complication rate was 6%. Conclusion: Total laparoscopic hysterectomy is a preferred method to abdominal hysterectomy because it is associated with a more favorable surgical outcome. The laparoscopic approach is an acceptable treatment modality in the current gynecological practice. Total laparoscopic hysterectomy is more beneficial to patients because of low estimated blood loss, less analgesia use, low intraoperative and postoperative complication rates, less postoperative pain, more rapid recovery, and short hospital stays. However, the percentage of total laparoscopic hysterectomies is still very low. The longer operation time in total laparoscopic hysterectomy, an unfavorable learning curve, and extensive training of surgeons and the whole surgical team are often cited as reasons.