Morbidity of 10 110 hysterectomies by type of approach (original) (raw)
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Audit of morbidity and mortality rates of 1792 hysterectomies
Journal of Minimally Invasive Gynecology, 2006
STUDY OBJECTIVE: To audit morbidity and mortality rates of laparoscopic, abdominal, and vaginal hysterectomy. DESIGN: Retrospective review of monthly morbidity and mortality rates (Canadian Task Force classification II-2). SETTING: University teaching hospital. PATIENTS: One thousand seven hundred ninety-two women who underwent hysterectomy for benign, nonobstetric indications at the Sir Mortimer B. Davis-Jewish General Hospital. INTERVENTIONS: Laparoscopic supracervical (LASH), vaginal (VH), and abdominal (AH) hysterectomies.
American Journal of Obstetrics and Gynecology, 1997
OBJECTIVE: We evaluated the advantages and disadvantages of laparoscopic hysterectomy over a 2-year period when this new technique was introduced to several hospitals in Finland. STUDY DESIGN" A nationwide register was founded and a prospective multicenter survey of 1165 laparoscopic hysterectomies was carried out from January 1993 to December 1994. The operations were performed because of uterine fibroids (54%), menorrhagia (27%), dysmenorrhea (8%), endometriosis (2%), and other reasons (9%) by 68 gynecologists at 30 hospitals. RESULTS: The mean operation time was 132 minutes. The patients stayed in hospital for an average of 3.3 days, and the mean convalescence period was 17.9 days, half that after abdominal hysterectomy. Complications occurred in 10.2% of the procedures: infections in 5.6%, vascular complications in 1.2%, urinary tract complications in 2.7%, and bowel complications in 0.4%. CONCLUSIONS: Laparoscopic hysterectomy offers a short hospital stay and convalescence time to the patient, but effective teaching is imperative to minimize, in particular, the risk of urinary tract injuries. (Am J Obstet Gynecol 1997;176:118-22.)
FINHYST, a prospective study of 5279 hysterectomies: complications and their risk factors
Human Reproduction, 2011
background: Hysterectomy guidelines highlight an increase in urinary tract injuries with laparoscopic hysterectomy (LH). This national survey analyses complications of LH, abdominal hysterectomy (AH) and vaginal hysterectomy (VH). methods: A prospective cohort undergoing hysterectomy for benign indications during 2006 was drawn from 53 hospitals in Finland; all communal hospitals participated. Detailed questionnaires covered surgical data and intra-and post-operative major and minor complications, for which risk factors were analysed by a multivariate logistic regression model adjusted for surgical data and patient characteristics.
A comparative study of laparoscopic and abdominal hysterectomies
Serbian Journal of Experimental and Clinical Research, 2008
This case study shows comparative results of laparoscopic and abdominal hysterectomies. It includes 503 hysterectomies in connection to myomas of the uterus, performed in the period between January 2000 and December 2006. There were 64 (12.75%) patients that underwent laparoscopic hysterectomy (LH) and 439 (87.28%) patients subjected to abdominal hysterectomy (AH). The average age of patients subjected to LH was 48.91 years; for those in the AH group, average age was 46.47 years (P<0.01). Statistically speaking, there was a considerable difference between AH and LH in the number of myomas (2.06 vs.2.90), volume (281.0373 cm 3 vs. 476.9426 cm 3 ) and weight of the uterus (236.25 grams vs. 431.53 grams). The average duration of surgical procedures for LH was 98.8 minutes, while the AH procedures lasted for an average of 67.52 minutes (p<0.01). The main advantages of laparoscopic interventions include minor deterioration in the quality of blood test results and fewer patients dem...
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2009
A retrospective review of medical records was performed to assess the incidence and types of significant complications encountered during laparoscopic hysterectomy which would affect the use of a laparoscopic approach versus other routes of hysterectomy. A total of 526 consecutive patients' medical data between January 1994 and August 2007 were reviewed. Two hundred and thirty-two laparoscopic-assisted vaginal hysterectomies and 294 total laparoscopic hysterectomies were performed at Monash Medical Centre, a Melbourne tertiary public hospital, and three Melbourne private hospitals, by or under the supervision of three surgeons. Sixteen significant complications occurred. There were two cases of ureteric fistula, two bladder injuries, two bowel obstructions, four postoperative haematomas, one case of a bladder fistula, four conversions to laparotomy and one superficial epigastric artery injury. Inpatient stay ranged from two to six days. Our complication and inpatient stay rates are consistent with the previously reported rates, although there has been a reduction of incidence of visceral injuries with experience and introduction of new equipment.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2001
Objective: hysterectomy for benign disorders is usually well tolerated, but complications do occur. The aim of this retrospective study is to document such complications. Patients and methods: between March 1991 and December 1998, 1604 patients (mean age: 46 years) underwent hysterectomy for benign disorders. Peroperative and early postoperative complications were recorded for the 1248 vaginal hysterectomies (8%), 190 laparoscopically assisted vaginal hysterectomies (12%), and 166 abdominal hysterectomies (10%). Results: none of the patients died. There were 15 bladder (0.9%) and one ureter injury (0.06%) with no signi®cant difference between routes. Intestinal injuries (0.6%) overall were more common when laparotomy was performed (2.4%). In 45 patients (2.8%), bleeding exceeded 500 ml. The rates were vaginal hysterectomy (2%, P < 0:001), laparotomy (6.7%), and laparoscopy (5.3%). The overall reoperation rate of 0.8% does not differ with the type of the procedure. Conclusion: Per and early postoperative complications after hysterectomy remain important and patients should be aware of them. In order to control complications and decrease the morbidity, a high-risk population should be de®ned based on the patients' history of pelvic surgery and endometriosis, on their parity and the size of their uterus. For these patients, the most appropriate route should be preferred and complications should be assessed using different tests and subsequently treated during the same procedure. #
Hysterectomy: surgical route and complications
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2002
Objectives: To compare the morbidity associated with abdominal, vaginal and laparoscopic hysterectomies in a group of patients suitable for anyone of these surgical routes. Study design: Retrospective analysis of 1000 consecutive hysterectomies. Results: The 513 patients were deemed to be suitable for hysterectomy by anyone of the three surgical routes. The overall complication rates were 34, 24 and 21% for abdominal, vaginal and laparoscopic hysterectomy, respectively. Multiple regression analysis showed that the morbidity was similar when confounding factors were allowed for, in particular the use of peri-operative antibiotics. Conclusions: The route of hysterectomy is not a major determining factor of peri-operative complications when other confounding variables are taken into account. #
Chinese journal of cancer research = Chung-kuo yen cheng yen chiu, 2016
To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy (LH) compared with abdominal hysterectomy (AH) in case of benign gynecological disease. A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies (3,539 LH vs.1,356 AH) between 2007 and 2013 was involved. Operative time (OT), estimated blood loss (EBL), intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed. The EBL (174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively), passing flatus (38.7±14.1 vs. 48.1±13.2 hours), days with indwelling catheter (1.5±0.6 vs. 2.2±0.8 days), use of analgesics (6.5% vs. 73.1%), intra-operative complication rate (2.4% vs. 4.1%), post-operative complication rate (2.3% vs. 5.7%), post-operative constipation (12.1% vs. 24.6%), mild and serious stress urinary incontinence (SUI) post-operative (P<0.001; P...
Evaluation of complications of abdominal and vaginal hysterectomy in non decent cases
2015
Introduction: Abdominal and vaginal hysterectomies are the two prominent operative modalities for various uterine conditions. However the indications for selecting a particular procedure in any setting may not be optimally defined. This study was undertaken to evaluate disease by comparing peri operative and post operative complications. at the department of OBGY Bharati Hospital, Sangli, fr vaginal and abdominal hysterectomy groups by convenience sampling. The primary outcome measures were operative time, primary haemorrhage, wound infection, post operative analgesia, febrile mor haemorrhage and secondary outcome measures were estimated
Evaluation of Early Post-Operative Complications of Hysterectomized Patients
SAS journal of surgery, 2021
Original Research Article Background: Hysterectomy is the surgical removal of the uterus. In a total hysterectomy, the uterus and cervix are removed. In some cases, the fallopian tubes and ovaries are removed along with the uterus. In subtotal hysterectomy, only the uterus is removed. Infectious complications after hysterectomy are most common, ranging from 10.5% for abdominal hysterectomy to 13.0% for vaginal hysterectomy and 9.0% for laparoscopic hysterectomy [1]. Objective: The purpose of the study was to evaluation of the early post-operative complication of Hysterectomized patients. Methods: The Study was conducted in the department of obstetrics and gynaecology of Dhaka Medical College Hospital, Dhaka, Bangladesh to find out the common indications of hysterectomy. 100 cases were randomly selected for the study whose common indication of hysterectomy. Clinical examination and evaluation were done from October 2004 to February 2005. Other necessary investigations were done if clinically indicated and to prepare the patient for anesthesia. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: Majority of cases who underwent hysterectomy were 31-40 years (52%) of age. Out of 100 cases most of patients (70%) underwent abdominal hysterectomy and only 30 (30%) cases underwent vaginal hysterectomy. Out of 33 cases, clinically diagnosed as leiomyoma of the uterus histopathology revealed leiomyoma in 24 cases. In uncomplicated abdominal and vaginal hysterectomy, the duration of surgery was almost same, vaginal hysterectomies needs slightly longer time. Average hospital stay after operation was same. Conclusion: Uterine weight was not affected the complication rate, estimated blood loss and length of hospital stay in total hysterectomy operation.