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Islam, Bassem. "Laparoscopic Hysterectomy Versus Abdominal Hysterectomy of Enlarged Uterus." Women Health Care and Issues 3, no. 1 (February 5, 2020): 01–08. http://dx.doi.org/10.31579/2642-9756/018.
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This prospective interventional to assess feasibility of total laparoscopic hysterectomy (LH) for uteri weighing 280 gm or more. The study included 120 patients divided to 60 patient conducted total laparoscopic hysterectomies and 60 patients conduct total abdominal hysterectomy as standard method. Full history taking, gynecologic examination and ultrasound examination were done to all patients. The following data were collected from every patient in all groups: Age, BMI, uterine weight, Operative time, Estimated intraoperative blood loss, Preoperative hemoglobin and postoperative hemoglobin deficit 12 hours after surgery, intraoperative and Post-operative complications, Time to resumption of bowel movements to normal, Length of hospital stay. The most common indication among our patients was fibroid uterus while adenomyosis came second. All operations were performed by the same surgeons and using the same technique. We observe BMI is not considering as obstacle in laparoscopic group with advancement of anesthesia and sealing system. The mean operating time was slightly but not significally lower in laparoscopic hysterectomy with highly significant difference in the estimated blood loss in favor of laparoscopic group. The total incidence of intra-operative and postoperative complication of patient submitted to laparoscopic hysterectomy lower than conventional hysterectomy group but not statically significantly. There was significant difference in pain scoring, earlier bowel movement and hospital stay in the arm of laparoscopic group.
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MATTHEWS, KIRK J., ELLEN BROCK, STEPHEN A. COHEN, and DAVID CHELMOW. "Hysterectomy in Obese Patients." Clinical Obstetrics and Gynecology 57, no. 1 (March 2014): 106–14. http://dx.doi.org/10.1097/grf.0000000000000005.
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El Shakhs, Soliman A., Moharam A. Mohamed, Mahmoud A. Shahin, and Ahmed M. Eid. "Laparoscopic versus open hysterectomies in obese patients." International Surgery Journal 5, no. 12 (November 28, 2018): 3893. http://dx.doi.org/10.18203/2349-2902.isj20185014.
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Background: Hysterectomy is one of the most frequently performed surgical procedure. Though there are three approaches in hysterectomy (open, vaginal and laparoscopic), still there are controversies regarding the optimal route for performing it.Methods: This prospective comparative study included 42 obese patients subjected for pan-hysterectomy as a treatment. The forty-two patients were allocated into two groups: group (A) subjected to laparoscopic pan-hysterectomy, group (B) subjected to open pan-hysterectomy.Results: There was significant difference between the two groups regarding mean operative time, blood loss, analgesic requirements and hospital stay, while no significant difference regarding intra-operative complications.Conclusions: Laparoscopic hysterectomy in obese patients has emerged as a viable, safe and better alternative to open hysterectomy amongst appropriately trained surgeons.
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IKRAM, M., SHAZIA JABEEN, and M. SAEED. "HYSTERECTOMY." Professional Medical Journal 19, no. 02 (February 22, 2012): 214–21. http://dx.doi.org/10.29309/tpmj/2012.19.02.2015.
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Abdominal hysterectomy, the procedure by which almost 90% of hysterectomies are currently being done. Laparoscopicassisted vaginal hysterectomy has been introduced as an alternative to abdominal hysterectomy, and is thought to allow a more rapid return tonormal activity. Laparoscopic assisted vaginal hysterectomy has less postoperative morbidity and quicker recovery than abdominalhysterectomy. Objective: To compare the laparoscopic assisted vaginal hysterectomy with total abdominal hysterectomy in term of operativetime, per operative blood loss and post-operative wound infection. Study Design: Randomized trial. Setting: This study was carried out in thedepartment of obstetrics and gynaecology, Shaikh Zayed Hospital, Lahore. Period: Six months (15th September, 2008 to 15th March 2009).Patients and methods: Eighty patients fulfilling the inclusion criteria were selected for this study. Patients were equally divided in two groups;group A (laparoscopic assisted vaginal hysterectomy) and group B (total abdominal hysterectomy). Operative time (in minutes), blood loss (inml) as estimated and post-operative wound infection was assessed by presence or absence of wound discharge, redness and edema aroundthe incision on 3rd, 5th and 7th post-operative day. Results: The mean ages of women in group A was 49.13+4.26 and 45.68+4.54 years ingroup B. The maximum number of parity between 3-4 was 19 in group A and 20 in group B. Mean weights of cases in group A was 65.60+10.45kilograms and 70.77+15.59 kilograms in groups B. The per-operative time in group A was 105.13+6.55 minutes and 83.38+14.82 minutes ingroup B. The mean blood loss in group A was 178.0+43.51 ml and 228.25+72.49 ml in group B. The wound discharge was not found in group A,while in group B, 4 cases (10%) on 3rd post-operative day, 6 cases (15%) on 5th post-operative day and 11 cases 27.5% on 7th post-operative.Conclusions: Laparoscopic assisted vaginal hysterectomy has a quicker post-operative recovery but at the expense of a bit long duration ofsurgery. Laparoscopic vaginal assisted hysterectomy is a feasible option in a selected group of patients who would otherwise require anabdominal hysterectomy. The drug requirement to control pain and level of pain experienced by patients were also significantly less.
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Scriven, Angela, and Anne Chesterton. "Information needs of hysterectomy patients." Nursing Standard 9, no. 7 (November 9, 1994): 36–37. http://dx.doi.org/10.7748/ns.9.7.36.s44.
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Perveen, Saima, Farrukh Naheed, and Asma Batool. "GYNAECOLOGICAL HYSTERECTOMY;." Professional Medical Journal 21, no. 03 (June 10, 2014): 432–35. http://dx.doi.org/10.29309/tpmj/2014.21.03.2121.
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Objective: To audit indications and outcome of hysterectomies in Fatima HospitalBaqai Medical University Karachi so as to improve the quality of care provided to patients. StudyDesign: Descriptive observational study. Place and Duration of Study: Department ofObstetrics and Gynaecology, Fatima hospital, Baqai Medical University Karachi from November2009 to November 2011. Patients and Methods: All patients undergoing hysterectomy forgynaecological conditions from 2009 to 2011were included in the study. Results:Hysterectomies for gynaecological conditions accounted for184 cases during the study period.Mean age of patient was 49 (range 30-60 years). Mean parity was 6 (range 0-11). The mostcommon indication for hysterectomy was fibroid uterus56(30.4%) cases, dysfunctional uterinebleeding 38 (20.6%) cases, and uterovaginal prolapse 10 (5.4%) cases. Abdominal hysterectomyaccounted for 174(96.6%) and vaginal hysterectomy accounted for 10 (5.4%) cases. Twenty six(14%) patients were found to be suffering from hypertension,6(3.3%)patients were suffering fromdiabetes mellitus. Wound infection occurred in 11 (6%) cases. No mortality was associated withhysterectomy during the study period. The duration of hospital stay was less in vaginal route ascompared to abdominal. Conclusions: An audit should be carried out every year to improve thelevel of care of patients and also the expertise of surgeon should be checked. The study hasshown that hysterectomy is a safe procedure but the high morbidity associated with thisprocedure is bothersome. The other options like endometrial ablation, intrauterine hormonaldevice like mirenaetc should also be considered. More efforts should be made on vaginalhysterectomies as it is economical and morbidity is less with it.
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IKRAM, MUHAMMAD, ZOONA SAEED, ROOHI SAEED, and Uhammad Saeed. "ABDOMINAL VERSUS VAGINAL HYSTERECTOMY;." Professional Medical Journal 15, no. 04 (March 10, 2008): 486–91. http://dx.doi.org/10.29309/tpmj/2008.15.04.2866.
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Objective: To evaluate abdominal versus vaginal hysterectomy in relation to operative and post operative complications.Design: Single centre cross sectional study. Place and duration: The Department of Obstetric and Gynaecology, Shaikh Zayed post graduateMedical institute and Hospital, Lahore from 1 November 2005 to 31 October 2006. Subject and methods: All the patients with benign st stindications for hysterectomy (abdominal and vaginal) were included except patients with serious / complicated medical disease. Relativeinformations were filled in a Performa and informations were taken from case records. Results: This audit report included 200 women. 23.3%patients of vaginal hysterectomy were in the age group of 40-45 years while 35.7%patients of abdominal hysterectomy were in the age of 51-55years. Main indication for abdominal hysterectomy (85.5%) was fibroid uterus while for vaginal hysterectomy (66.6%) was Uterovaginal prolapse.Most common immediate post operative complication in abdominal and vaginal hysterectomy was fever in 42.8% and 20.0% respectively.Intraoperative visceral injuries were done in 4 patients in abdominal hysterectomy while no injury was done in vaginal hysterectomy. 44(80%)patients of vaginal hysterectomy were discharged with in 7 days of hospitalization while 64 (44%) patients of abdominal hysterectomy weredischarged with in 7 days of hospitalization. Conclusion: Hysterectomy either abdominal or vaginal is very safe and there were no lethalcomplication except few minor complications and also there was no mortality.
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Shrestha, R., and LH Yu. "Comparison between Laparoscopic Hysterectomy and Abdominal Hysterectomy." Nepal Journal of Obstetrics and Gynaecology 9, no. 1 (September 28, 2014): 26–28. http://dx.doi.org/10.3126/njog.v9i1.11183.
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Aims: Hysterectomy can be performed by abdominal, vaginal and laparoscopic methods. Laparoscopic hysterectomy has been reported as an alternative to traditional abdominal hysterectomy with benefit of early recovery, short hospital stay and less operative complications. This study compared laparoscopic versus abdominal hysterectomy in terms of surgery time, blood loss, post-operative recovery, and duration of hospital stay. Methods: This is a retrospective comparative study among sixty patients who underwent laparoscopic or abdominal hysterectomy for various indications in the Department of Obstetrics and Gynaecology of the Third affiliated hospital of Zhengzhou University from January to March 2007. The data of the patients meeting the set criteria were obtained from the hospital records and hospital based computerized coding system. Enrolled cases were divided in two groups with thirty in each arm. Group TLH (total laparoscopic hysterectomy) was designated for patients who underwent total laparoscopic hysterectomy and group TAH (total abdominal hysterectomy) for those who underwent total abdominal hysterectomy. Results: There was comparatively less blood loss in TLH group (60.2±5.17 ml versus 75.7±7.12 ml) but it was statistically insignificant (p=0.12). The laparoscopic hysterectomy took longer time (107.6±32.4 min versus 74.9±31.1 min) than the abdominal (p<0.001). There was early recovery among TLH group 1.6±0.6 days versus 2.1±0.5 days in TAH group (p=0.001). Mean duration of hospital stay was significantly shorter in TLH group 7.6±1.9 days versus 10.1±2.1 days in TAH group (p<0.001). Conclusions: Laparoscopic hyserectomy is an effective alternative to abdominal hysterectomy with the advantage of less intra-operative blood loss, fast recovery and short hospital stay. DOI: http://dx.doi.org/10.3126/njog.v9i1.11183 NJOG 2014 Jan-Jun; 2(1):26-28
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El-Dorf, Ayman. "Minilaparotomy hysterectomy Versus laparoscopic hysterectomy for benign uterine lesions A Comparative study." Women Health Care and Issues 3, no. 4 (December 28, 2020): 01–06. http://dx.doi.org/10.31579/2642-9756/037.
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Background: Hysterectomy is world wide's second most commonly done gynecological surgery, second only to the caesarean section. There is no general consensus, however, about the optimal hysterectomy process. Hysterectomy may be achieved through different techniques such as stomach, vaginal and laparoscopic. The goal of the study is to explore whether the hysterectomy of minilaparotomy for benign uterine lesions may be a viable option to laparoscopic hysterectomy in terms of short-term operational and postoperative performance. Methods: 105 patients who were due to undergo complete hysterectomy for a benign uterine lesion were split into 3 categories according to their preference of therapeutic therapy method: group A (35 patients) minilaparotomy hysterectomy utilizing traditional sutures. Group B (35 patients) minilaparotomy hysterectomy utilizing bipolar vessel sealing procedure (Ligasure). Group C (35patients) laparoscopic hysterectomy using Ligasure. Result (s): The operating time in Group A (84.71 ± 9.91 minutes), group B (55.31 ± 7.81 minutes), while group C (94.81 ± 16.1 minutes).The duration until resumption of intestinal sounds in group C (12.31 ± 2.51 hours) in comparison to group A (17.41 ± 1.91 hours) and group B (16.51 ± 1.761 hours). Blood loss in group B (99.11 ± 30.81 ml), group A (130.31 ± 54.41 ml) and group C (136.61 ± 6.61 ml). The longest hospital stay occurred in group A (31.8 1± 5.71 hours) versus groups B (20.71 ± 2.51 hours) and C (19.31 ± 6.1 hours). The highest pain score was observed in group A (5.21 ± 1.11) versus groups B (3.81 ± 1.61) and C (3.71 ± 1.21). There was no significant difference in the incidence of intraoperative or postoperative complications. Conclusion (s): Less operational time and intraoperative blood loss were correlated with the usage of ligasure bipolar vessel sealing device in minilaparotomy hysterectomy, whereas it was comparable to laparoscopic hysterectomy in hospital stay and low morbidity postoperative pain scoring and a limited hospital stay. It can be an acceptable alternative to laparoscopic hysterectomy, suitable in areas without laparoscopic experience or facilities.
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Pervin, Shahana, Farzana Islam Ruma, Khadija Rahman, Jannatul Ferdous, Rifat Ara, Mollah Mohamed Abu Syed, and Annekathryn Goodman. "Adjuvant Hysterectomy in Patients With Residual Disease After Radiation for Locally Advanced Cervical Cancer: A Prospective Longitudinal Study." Journal of Global Oncology, no. 5 (December 2019): 1–7. http://dx.doi.org/10.1200/jgo.18.00157.
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PURPOSE The aim of the study was to evaluate the efficacy of hysterectomy in the control of pelvic disease in patients with post-irradiated residual cervical cancer. PATIENTS AND METHODS Forty patients were treated at either National Institute of Cancer Research and Hospital (NICRH) or Delta Cancer Hospital in Dhaka, Bangladesh, with International Federation of Gynecology and Obstetrics stage IIB to IIIB disease with residual disease after the following: either concurrent chemoradiation with or without brachytherapy, induction chemotherapy and external-beam radiotherapy (EBRT) with or without brachytherapy, or only EBRT. Patients were treated by either radical hysterectomy or extrafascial hysterectomy. RESULTS From 2009 to June 2013, 55 patients were evaluated for central residual disease on their presentations to NICRH or Delta Hospital. Patients with distant recurrences after primary radiation were excluded. Forty patients had invasive cancer on biopsy and underwent either radical hysterectomy or extrafascial hysterectomy. Surgery was performed 14 to 18 weeks after the initial treatment. Of the 29 women who underwent extrafascial hysterectomy, four (13.8%) developed recurrent disease, and one died; none of the 11 patients treated by radical hysterectomy experienced recurrences during the study period. Morbidity was increased in patients who underwent radical hysterectomy. Overall 90% of patients (36 of 40 patients) who underwent surgery had no evidence of disease at 5 years of follow-up. CONCLUSION Surgery is a viable treatment option for patients with residual cervical cancer after radiation. Radical hysterectomy after radiation is more morbid but has better tumor control than extrafascial hysterectomy.
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Kumar, Raj, Selvapriya Saravanan, and Lakshmi Subburaj. "Clinical Profile of Patients Undergoing Laparoscopic Hysterectomy." Journal of South Asian Federation of Obstetrics and Gynaecology 12, no. 5 (2020): 277–80. http://dx.doi.org/10.5005/jp-journals-10006-1823.
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ABSTRACT Background Laparoscopic hysterectomy is a minimally invasive procedure with shorter operative time, decreased trauma, and less technical difficulty. However, the success of the procedure depends on various intrinsic and extrinsic factors. This study was done to evaluate the factors which influence the success of laparoscopic hysterectomy. Materials and methods This retrospective record-based cross-sectional study was carried out among 100 participants who underwent laparoscopic hysterectomy for various indications in our tertiary care hospital. The demographic and clinical profiles of these participants were recorded. Particulars related to the success of the surgery including duration of surgery and hospital stay, infections, and other complications were recorded. Results Our study showed that the duration of surgery and duration of hospital stay were significantly influenced by the parity. Multiparous women were more prone to longer duration of surgery and prolonged hospitalization. The observed difference was statistically significant (p < 0.05). Conclusion It is essential to develop a scoring mechanism by which each case can be selected or rejected for laparoscopic hysterectomy considering various parameters. This may be carried out by further exploratory research on identifying the key factors which influence the success of the procedure. How to cite this article Subburaj L, Saravanan S, Kumar R. Clinical Profile of Patients Undergoing Laparoscopic Hysterectomy. J South Asian Feder Obst Gynae 2020;12(5):277–280.
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TAHIRA, TASNIM, SAIMA QURESHI, and MAHNAZ ROOHI. "ABDOMINAL HYSTERECTOMY." Professional Medical Journal 14, no. 04 (October 12, 2007): 685–88. http://dx.doi.org/10.29309/tpmj/2007.14.04.4838.
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Objective:(1)To audit cases of abdominal hysterectomy performed by post graduate tainees. (2) Toevaluate mortality and morbidity rate. Study Design: An observational Study. Setting: Department of Obstetrics andgynaecology, Allied Hospital Faisalabad. Period: From 01-01-2005 to 30-06-2006. Material & Methods:120 casesof abdominal hysterectomies done for non obstetric and benign gynaecological conditions were selected for study.Results: The most common indications for hysterectomy was DUB (43.3%). Overall intra operative complicationsdeveloped in 5 patients (4.1%). Post operative complications developed in 9 patients (7.5%). The mean duration ofhospital stay was 5.5 days. No case of death was recorded in the study. Conclusion: This study demonstrates thatabdominal hysterectomy can be safely done even during the learning curve of the post graduate trainees with the lowcomplication rate, shorter hospital stay and without significant mortality.
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Sajjad, Nazia, Sara Qadir, Rukhsana Kasi, Tayyaba Rasheed, Fozia Unar, and Tanweer Akhtar. "Comparison of Post-Operative Quality of Life between Vaginal Hysterectomy and Abdominal Hysterectomy." Pakistan Journal of Medical and Health Sciences 15, no. 7 (July 26, 2021): 1801–3. http://dx.doi.org/10.53350/pjmhs211571801.
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Objectives: To compare the frequency of satisfactory quality of life between vaginal hysterectomy and abdominal hysterectomy. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Obstetrics and Gynecology, Niazi Medical & Dental College, Sargodha from 1st April 2020 to 31st December 2020. Methodology: Ninety patients were comprised and they were divided in two groups; group A (vaginal hysterectomy) and Group B (abdominal hysterectomy) were performed. Hysterectomies (vaginal or abdominal) were performed by consultant gynecologist having experience at having least 5 years). Results: Mean age of the patients was 49.82±3.207 years, mean age of the patients of group A was 49.82±3.193 years and mean age of the patients of group B was 49.82±3.256 years. Satisfactory quality of life was noted in 38 (84.44%) patients of study group A and 29 (64.44%) patients of study group B. Statistically significant (P = 0.051) difference between the frequency of satisfactory quality of life between the both groups was noted. Conclusion: Results of this study reveals that post hysterectomy quality of life found more satisfactory in vaginal hysterectomy group as compared to abdominal hysterectomy group. Insignificant association of post hysterectomy quality of life with age group, marital status, parity and socio-economical status was found. Findings of this study also revealed that post hysterectomy satisfactory quality of life is not associated with education of the patients. Key words: Hysterectomy, Quality of life, abdomen, vagina, WHO, Uterus
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Takahashi, Hironori, Akihide Ohkuchi, Rie Usui, Hirotada Suzuki, Yosuke Baba, and Shigeki Matsubara. "Factors Contributing to Massive Blood Loss on Peripartum Hysterectomy for Abnormally Invasive Placenta: Who Bleeds More?" Obstetrics and Gynecology International 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/5349063.
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Introduction. To identify factors that determine blood loss during peripartum hysterectomy for abnormally invasive placenta (AIP-hysterectomy).Methods. We reviewed all of the medical charts of 11,919 deliveries in a single tertiary perinatal center. We examined characteristics of AIP-hysterectomy patients, with a single experienced obstetrician attending all AIP-hysterectomies and using the same technique.Results. AIP-hysterectomy was performed in 18 patients (0.15%: 18/11,919). Of the 18, 14 (78%) had a prior cesarean section (CS) history and the other 4 (22%) were primiparous women. Planned AIP-hysterectomy was performed in 12/18 (67%), with the remaining 6 (33%) undergoing emergent AIP-hysterectomy. Of the 6, 4 (4/6: 67%) patients were primiparous women. An intra-arterial balloon was inserted in 9/18 (50%). Women with the following three factors significantly bled less in AIP-hysterectomy than its counterpart: the employment of an intra-arterial balloon (4,448±1,948versus8,861±3,988 mL), planned hysterectomy (5,003±2,057versus9,957±4,485 mL), and prior CS (5,706±2,727versus9,975±5,532 mL). Patients with prior CS (−) bled more: this may be because these patients tended to undergo emergent surgery or attempted placental separation.Conclusion. Patients with intra-arterial balloon catheter insertion bled less on AIP-hysterectomy. Massive bleeding occurred in emergent AIP-hysterectomy without prior CS.
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Göksever Çelik, Hale, Engin Çelik, Gökçe Turan, Kerem Doğa Seçkin, and Ali Gedikbaşı. "Risk factors for surgical site infection after hysterectomy." Journal of Infection in Developing Countries 11, no. 04 (April 30, 2017): 355–60. http://dx.doi.org/10.3855/jidc.9053.
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Introduction: The aim of the study was to define the clinical and laboratory characteristics of patients who had surgical site infection (SSI) after hysterectomy. Methodology: This study was a retrospective cohort study. The patient data of 840 subjects who had undergone any type of hysterectomy and reported SSI after surgery were obtained from the archives of a tertiary referral center. The different types of hysterectomy procedures performed on these patients included total abdominal hysterectomy (TAH), laparoscopic hysterectomy (LH), and vaginal hysterectomy (VH). In addition, age, body mass index (BMI), preoperative and postoperative blood parameters, gravidity, and parity were also documented. Results: TAH, LH, and VH were performed on 63.2% (n = 531), 21.6% (n = 181), and 15.2% (n = 128) of patients, respectively. Overall, SSIs were observed in 3.7% (n = 31) of all hysterectomy patients. Among them, 4.5% of TAH patients, 1.7% of LH patients, and 3.1% of VH patients had SSIs after the hysterectomy operation. Analysis of the data revealed that the patients with SSIs had significantly higher BMIs, lower preoperative hemoglobin, lower postoperative hemoglobin and hematocrit, and higher postoperative platelet counts compared to patients who did not have any SSIs. Conclusions: High BMI, blood loss during surgery, low hematocrit levels, and resulting anemia increased the incidence of SSI after hysterectomy. Among the different types of hysterectomy, LH was found to be relatively better than TAH and VH in preventing the occurrence of SSI.
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Shimada, Muneaki, Hideki Tokunaga, Hiroaki Kobayashi, Mitsuya Ishikawa, and Nobuo Yaegashi. "Perioperative treatments for stage IB–IIB uterine cervical cancer." Japanese Journal of Clinical Oncology 50, no. 2 (December 23, 2019): 99–103. http://dx.doi.org/10.1093/jjco/hyz200.
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Abstract Japan Society of Gynecologic Oncology guidelines recommended either radical hysterectomy-based approach or the definitive radiotherapy including concurrent chemoradiotherapy as primary treatment for patients with not only stage IB1/IIA1, but also stages IB2, IIA2 and IIB. Based on pathological findings of surgical specimens, patients who underwent radical hysterectomy are divided into three recurrent-risk groups, low-risk, intermediate, and high-risk groups. Although some authors reported the usefulness of adjuvant chemotherapy for intermediate/high-risk patients, radiotherapy was standard adjuvant treatment for pathological-risk patients after radical hysterectomy. It has been uncertain whether neoadjuvant chemotherapy followed by radical hysterectomy is beneficial for stage IB2–IIB patients. Recently, the randomized phase III study revealed that neoadjuvant chemotherapy followed by radical hysterectomy failed to improve survival of stage IB2–IIB patients compared to concurrent chemoradiotherapy. Majority of stage IB2–IIB patients are required adjuvant radiotherapy after radical hysterectomy. The multimodality strategy consisting of radical hysterectomy followed by adjuvant radiotherapy is associated with not only impaired quality of life, but also conflicting of cost-effectiveness. Thereby, some authors investigated the significance of multimodality strategy consisting of chemotherapy before/after radical hysterectomy for stage IB2–IIB cervical cancer. Multimodality strategy consisting of radical hysterectomy/perioperative chemotherapy needs higher curability of radical hysterectomy, higher response to perioperative chemotherapy and less perioperative complications. Consequently, gynecologic oncologists have to examine the patients strictly before treatment and judge whether radical hysterectomy-based approach or definitive irradiation is appropriate for the patient with stage IB–IIB cervical cancer.
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Bogani, Giorgio, Fabio Ghezzi, Luis Chiva, Baldo Gisone, Ciro Pinelli, Andrea Dell'Acqua, Jvan Casarin, Antonino Ditto, and Francesco Raspagliesi. "Patterns of recurrence after laparoscopic versus open abdominal radical hysterectomy in patients with cervical cancer: a propensity-matched analysis." International Journal of Gynecologic Cancer 30, no. 7 (May 23, 2020): 987–92. http://dx.doi.org/10.1136/ijgc-2020-001381.
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ObjectiveRecent evidence has suggested that laparoscopic radical hysterectomy is associated with an increased risk of recurrence in comparison with open abdominal radical hysterectomy. The aim of our study was to identify patterns of recurrence after laparoscopic and open abdominal radical hysterectomy for cervical cancer.MethodsThis a retrospective multi-institutional study evaluating patients with recurrent cervical cancer after laparoscopic and open abdominal surgery performed between January 1990 and December 2018. Inclusion criteria were: age ≥18 years old, radical hysterectomy (type B or type C), no recurrent disease, and clinical follow-up >30 days. The primary endpoint was to evaluate patterns of first recurrence following laparoscopic and open abdominal radical hysterectomy. The secondary endpoint was to estimate the effect of the primary surgical approach (laparoscopy and open surgery) in post-recurrence survival outcomes (event-free survival and overall survival). In order to reduce possible confounding factors, we applied a propensity-matching algorithm. Survival outcomes were estimated using the Kaplan-Meier model.ResultsA total of 1058 patients were included in the analysis (823 underwent open abdominal radical hysterectomy and 235 patients underwent laparoscopic radical hysterectomy). The study included 117 (14.2%) and 35 (14.9%) patients who developed recurrent cervical cancer after open or laparoscopic surgery, respectively. Applying a propensity matched comparison (1:2), we reduced the population to 105 patients (35 vs 70 patients with recurrence after laparoscopic and open radical hysterectomy). Median follow-up time was 39.1 (range 4–221) months and 32.3 (range 4–124) months for patients undergoing open and laparoscopic surgery, respectively. Patients undergoing laparoscopic radical hysterectomy had shorter progression-free survival than patients undergoing open abdominal surgery (HR 1.98, 95% CI 1.32 to 2.97; p=0.005). Patients undergoing laparoscopic radical hysterectomy were more likely to develop intrapelvic recurrences (74% vs 34%; p<0.001) and peritoneal carcinomatosis (17% vs 1%; p=0.005) than patients undergoing open surgery.ConclusionsPatients undergoing laparoscopic radical hysterectomy are at higher risk of developing intrapelvic recurrences and peritoneal carcinomatosis. Further evidence is needed in order to corroborate our findings.
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Kim, Jong Hyeok, Sang Soo Lee, Dae Yeon Kim, Tian Fu Jin, Yong Man Kim, Young Tak Kim, Jung Eun Mok, and Joo Hyun Nam. "Laparoscopically-assisted Vaginal Hysterectomy Versus Abdominal Hysterectomy in Patients with Endometrial Cancer." Korean Journal of Gynecologic Oncology and Colposcopy 14, no. 4 (2003): 321. http://dx.doi.org/10.3802/kjgoc.2003.14.4.321.
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Read, Carol. "Early discharge schemes for hysterectomy patients." Nursing Standard 10, no. 42 (July 10, 1996): 43–45. http://dx.doi.org/10.7748/ns.10.42.43.s48.
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Mushtaler, J., and J. Herd. "Hysterectomy outcomes from the patients' perspective." Journal of the American Association of Gynecologic Laparoscopists 8, no. 3 (August 2001): S45. http://dx.doi.org/10.1016/s1074-3804(01)80149-3.
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Bangarulingam, Sanjay, Prithesh Mutha, and Ravi Vachhani. "Adenoma Detection Rate in Hysterectomy Patients." American Journal of Gastroenterology 110 (October 2015): S588. http://dx.doi.org/10.14309/00000434-201510001-01355.
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Mathur, Kusum Lata, Manu Sharma, Mohua Mazumdar, Shikha Talati, and Siddharth Srivastav. "Psychological well-being, marital adjustment and quality of life after hysterectomy: a comparative study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 12 (November 26, 2018): 4960. http://dx.doi.org/10.18203/2320-1770.ijrcog20184948.
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Background: Hysterectomy is the most common major gynecological surgery often performed for benign lesions. Many studies have reported adverse psychosocial outcomes post-hysterectomy. There is a paucity of studies from India addressing psychiatric morbidity after hysterectomy. To evaluate psychological wellbeing, marital adjustment and quality of life in patients undergoing hysterectomy for non-malignant conditions, in comparison with patients undergoing surgery other than hysterectomy.Methods: A cross-sectional study was conducted on 100 consecutive out-patients who underwent hysterectomy for non-malignant indications at least 6 months ago. The comparison group comprised of 50 consecutive out-patients who underwent gynecological surgery other than hysterectomy at least 6 months ago formed the comparison group. The study participants were evaluated on Hospital Anxiety and Depression Scale (HADS), Psychological General Well-being Index (PGWBI), Marital Adjustment Test (MAT) and Women’s Quality of Life Questionnaire (WOMQOL).Results: The indications for hysterectomy were: uterine leiomyoma (69%), uterovaginal prolapse (18%), dysfunctional uterine bleeding (12%), and endometriosis (1%). Abdominal hysterectomy was performed in 92 patients while 8 patients underwent vaginal hysterectomy. There were no significant differences in the study groups on scores of HADS, PGWBI, MAT and WOMQOL (p>0.05). Both the study groups had good marital adjustment and majority reported no depression and anxiety.Conclusions: There is no major psychiatric morbidity, decline in marital adjustment and quality of life after hysterectomy for benign conditions among Indian women. Future research on the ethno-cultural implications and effect of hysterectomy on mental health will be a significant addition to the available evidence in India.
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Hu, Ting wen yi, Yue Huang, Na Li, Dan Nie, and Zhengyu Li. "Comparison of laparoscopic versus open radical hysterectomy in patients with early-stage cervical cancer: a multicenter study in China." International Journal of Gynecologic Cancer 30, no. 8 (June 22, 2020): 1143–50. http://dx.doi.org/10.1136/ijgc-2020-001340.
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IntroductionRecently, the safety of minimally invasive surgery in the treatment of cervical cancer has been questioned. This study was designed to compare the disease-free survival and overall survival of abdominal radical hysterectomy and laparoscopic radical hysterectomy in patients with early-stage cervical cancer.MethodsA total of 1065 patients with early-stage cervical cancer who had undergone abdominal/laparoscopic radical hysterectomy between January 2013 and December 2016 in seven hospitals were retrospectively analyzed. The 1:1 propensity score matching was performed in all patients. Patients with tumor size ≥2 cm and <2 cm were stratified and analyzed separately. Disease-free survival and overall survival were compared between matched groups. After confirming the normality by the Shapiro-Wilks test, the Mann-Whitney U test and the χ2 test were used for the comparison of continuous and categorical variables, respectively. The survival curves were generated by the Kaplan-Meier method and compared by log-rank test.ResultsAfter matching, a total of 812 patients were included in the disease-free survival and overall survival analyses. In the entire cohort, the laparoscopic radical hysterectomy group had a significantly shorter disease-free survival (HR 1.65, 95% CI 1.00 to 2.73; p=0.048) but not overall survival (HR 1.60, 95% CI 0.89 to 2.88; p=0.12) when compared with the abdominal radical hysterectomy group. In patients with tumor size ≥2 cm, the laparoscopic radical hysterectomy group had a significantly shorter disease-free survival (HR 1.93, 95% CI 1.05 to 3.55; p=0.032) than the abdominal radical hysterectomy group, whereas no significant difference in overall survival (HR 1.90, 95% CI 0.95 to 3.83; p=0.10) was found. Additionally, in patients with tumor size <2 cm, the laparoscopic radical hysterectomy and abdominal radical hysterectomy groups had similar disease-free survival (HR 0.71, 95% CI 0.24 to 2.16; p=0.59) and overall survival (HR 0.59, 95% CI 0.11 to 3.13; p=0.53).ConclusionLaparoscopic radical hysterectomy was associated with inferior disease-free survival compared with abdominal radical hysterectomy in the entire cohort, as well as in patients with tumor size ≥2 cm. For the surgical treatment of patients with early-stage cervical cancer, priority should be given to open abdominal radical hysterectomy.
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Patel, Rinkal, and Tajeal Patel. "Comparative Study of Non-Descent Vaginal Hysterectomy with Abdominal Hysterectomy." Journal of Medical Research and Innovation 2, S1 (November 3, 2018): e000157. http://dx.doi.org/10.32892/jmri.157.
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Aims and Objectives: 1) To compare safety and operative complications in abdominal versus vaginal routes of hysterectomy. 2) To compare the length of stay in hospital with regard to the route of hysterectomy. 3) To compare the postoperative morbidity in abdominal versus vaginal routes of hysterectomy.
Methodology: The study is a prospective study conducted in the department of obstetrics and Gynecology. Civil hospital, Ahmedabad between the period of Jan 2016 to 2017. Of 100 patients. Fifty patients who underwent hysterectomy by vaginal route are taken as study group A, and the remaining 50 patients who underwent by the abdominal route are taken as study group B. Inclusion criteria for hysterectomy are: 1. Uterine benign diseases such as fibroids, adenomyosis and CIN. 2. Gynecological symptoms that justified total hysterectomy. 3. Patients without fertility requirement. 4. Patients who gave informed consent to participate. Exclusion criteria for hysterectomy are: 1. Uterine size more than 12 week of gravid uterus. 2. Highly restricted uterine mobility. 3. Malignancy 4. Patient with fertility requirement.
Results: Majority of women undergoing hysterectomy were in age group of 30-50 years; postmenopausal age group women were less;13 NDVH and 5 in AH. Majority of the women were multipara in both age groups. Menorrhagia was found to be major indication with 42 in NDVH and 40 in AH. There is much significant difference in the postoperative pain in both groups with less in NDVH group. There is not much significant difference in blood loss in both the groups. Postoperative complications were more with AH.
Conclusion: Thus, it can be concluded that NDVH is feasible, safe and provide more patient comfort without increasing the duration of surgery and other post –operative complications.
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Mayor, Paul, John Etter, James Brian Szender, Emese Zsiros, Peter Jonathan Frederick, and Shashikant B. Lele. "Performing combined breast and gynecologic surgery does not increase the rate of surgical site infections: A NSQIP database analysis." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e18093-e18093. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18093.
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e18093 Background: The purpose of this study is to determine and compare the overall rates of surgical site infections (SSI) in patients undergoing breast surgery, hysterectomy and combined breast surgery and hysterectomy. Methods: We inspected the National Surgical Quality Improvement Program (NSQIP) Participant Use Files from 2005-2014 for subjects undergoing breast surgery (CPT codes 19300-19307, 19340, 19342, 19350, 19357, 19361, 19364, 19366-19369, 19380, 19396), Gynecologic surgery ( CPT Codes 58150, 58152, 58180, 58200, 58210, 58240, 58260, 58262, 58263, 58267, 58270, 58275, 58280, 58285, 58290-58294, 58541-58544, 58548, 58550, 58552-58554, 58570-58573), or a combined surgery (the NSQIP databased was queried for encounters that contained both a breast surgery code and hysterectomy procedure code). We then queried the database for SSI rates within 30 days of surgery. SSI rates were compared using a χ2 test with a nominal value of p < 0.05 as a test for significance. Results: We identified a total of 174,605 patients who underwent a breast surgery and found a SSI rate of 2.59%. We identified a total of 137,121 patients who underwent hysterectomy and found a SSI rate of 2.58%. We identified 383 patients who underwent a combined breast surgery and hysterectomy and found a SSI rate of 2.87%. When comparing SSI rates of combined breast surgery and hysterectomy, to breast surgery or hysterectomy alone, we found no significant difference in the rates of SSI between these groups (p = .7304). We analyzed SSI rates in patients by different surgical approaches including combined breast surgery and open hysterectomy and found an SSI rate of 4.35% (p = .357), combined breast surgery and laparoscopic hysterectomy and found an SSI rate of 2.38% (p = .931), and combined breast surgery and laparoscopic assisted vaginal hysterectomy and found an SSI rate of 2.75% (p = .916). Conclusions: The rates of SSI in patients undergoing combined breast surgery and hysterectomy is not significantly different from breast surgery or hysterectomy alone. Gynecologic oncologist should coordinate with breast surgeons to perform a combined procedure in patients who require both breast surgery and hysterectomy.
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Kahnum, Zohra, Amna Kahnum, Aman ur Rehman, and Liaqat Ali. "LAPAROSCOPIC HYSTERECTOMY." Professional Medical Journal 23, no. 02 (October 10, 2016): 166–70. http://dx.doi.org/10.29309/tpmj/2016.23.02.1062.
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Introduction: In current era, the trend for minimal invasive surgery is increaseddue to its established advantages. With the same, there increasing trend for laparoscopichysterectomy. But it carries certain risks in certain situations. Objectives: The study wasconducted to see the outcome of laparoscopic hysterectomies. Study Design: Retrospective,analytic study. Study Period: June 2012 to May, 2015. Method: A study was conducted to reviewthe outcome of Laparoscopic hysterectomy over a period of three years from June 2012 to May2015. Total one hundred cases were included in the study. These patients had hysterectomyeither total laparoscopic hysterectomy or laparoscopic assisted vaginal hysterectomy. Afterpreoperative evaluation, hysterectomy was done either total laparoscopic or laparoscopicassisted vaginal hysterectomy. Data was collected regarding patients profile variables,indications for hysterectomy, intraoperative findings, intraoperative time, postoperative recoveryfindings, analgesia requirements and discharge time from the hospital. Results: Results of thestudy showed that there was no significant increase in complication of urinary tract or bowelinjury. Operative time was decreased with time. Most common indication for hysterectomywas fibroid uterus or dysfunctional uterine bleeding. Patient recovery was smooth and postoperativeanalgesia was much less as compared to the routine. Patient hospital stay was lessas compared to the routine procedures for hysterectomy. Conclusion: It is concluded fromthe study that laparoscopic hysterectomy is safe procedure with the clear advantages for thepatient. In the study complication rate, operating time was comparable to the already publishedstudies. With proper training it is acceptable alternate to abdominal hysterectomy with clearadvantages for the patient.
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Tomov, Slavcho T., Grigor A. Gortchev, Latchesar S. Tantchev, Todor I. Dimitrov, Chavdar A. Tzvetkov, and Savelina L. Popovska. "Perioperative Outcomes Of Laparoscopic Hysterectomy: Comparison With Abdominal, Vaginal, And Robot-Assisted Surgical Approaches." Journal of Biomedical and Clinical Research 8, no. 1 (June 1, 2015): 52–60. http://dx.doi.org/10.1515/jbcr-2015-0152.
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SummarySelection of an appropriate surgical method for hysterectomy in an individual patient is currently an issue that remains open and debatable. This study aimed to analyze perioperative outcomes in gynecologic patients who underwent laparoscopic hysterectomy at a single institution during a 6-year period and to compare the data for simple hysterectomy patients treated with different surgical approaches. The study included a retrospective analysis of demographics, pre- and post-operative characteristics of 1,023 patients, operated on using four types of simple hysterectomy approaches: 635 laparoscopic hysterectomies (62.1%), 289 total abdominal hysterectomies (28.3%), 45 total vaginal hysterectomies (4.4%) and 54 robotic-assisted hysterectomies (5.3%). For the laparoscopic hysterectomy group, the mean operative time was shorter as compared to the abdominal and vaginal hysterectomy groups (p<0.05), as well as a significantly shorter hospital length-of-stay when compared to the abdominal, robotic or vaginal hysterectomy groups (p<0.05). Regression analysis revealed significant linear correlation between operative time and body-mass index of laparoscopic hysterectomy patients (R2 =0.008; p=0.026). Complications emergence and hemotransfusion often prolonged the mean operative time significantly by 17.8 min (p=0.002) and 15.5 min, respectively (p<0.001). The rate of major complications was significantly higher in the laparoscopic vs. abdominal groups (p<0.05). Clinical outcomes in patients operated on with laparoscopic hysterectomy were better than in those operated with total abdominal and vaginal hysterectomy in terms of operative time and hospital length-of-stay. Prospective randomized multi-center studies would be desirable to further define the place of the modern minimally invasive hysterectomy approaches.
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Lee, Jung-Yun, Jae-Weon Kim, Kidong Kim, Myong Cheol Lim, and Jin Hee Kim. "Comparative effectiveness of laparoscopic radical hysterectomy for cervical cancer." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e17015-e17015. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e17015.
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e17015 Background: Despite the benefits of minimally invasive surgery for cervical cancer, population-level data describing the surgery’s effectiveness in unselected patients are lacking. We compared morbidity, cost, and survival between abdominal radical hysterectomy and laparoscopic radical hysterectomy for cervical cancer. Methods: We used the Korean Health Insurance Review and Assessment Service database to identify women with cervical cancer who underwent radical hysterectomy from 2011 to 2014. Patient who underwent abdominal radical hysterectomy were compared with those who had minimally invasive hysterectomy. Perioperative morbidity, use of adjuvant therapy, and survival were evaluated. Results: We identified 6,335 patients including 3,235 who underwent abdominal radical hysterectomy and 3,100 who underwent laparoscopic radical hysterectomy. Uptake of laparoscopic radical hysterectomy increased from 46.1% in 2011 to 51.8% in 2014. Patients who were younger and treated at larger hospital were more likely to undergo laparoscopic procedure (P<0.001). Laparoscopic radical hysterectomy had lower rates of complication, less transfusion requirement, shorter hospital stays, and reduced total medical costs (P<0.001). There was no significant association between use of laparoscopic approach and recurrence-free survival (P=0.194). Conclusions: Laparoscopic radical hysterectomy was associated with lower risk of perioperative complication and have comparable outcomes with abdominal radical hysterectomy.
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Al Sawah, Entidhar, Jason L. Salemi, Mitchel Hoffman, Anthony N. Imudia, and Emad Mikhail. "Association between Obesity, Surgical Route, and Perioperative Outcomes in Patients with Uterine Cancer." Minimally Invasive Surgery 2018 (June 19, 2018): 1–8. http://dx.doi.org/10.1155/2018/5130856.
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Objective. To study temporal trends of hysterectomy routes performed for uterine cancer and their associations with body mass index (BMI) and perioperative morbidity. Methods. A retrospective review of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) 2005-2013 databases was conducted. All patients who were 18 years old and older with a diagnosis of uterine cancer and underwent hysterectomy were identified using ICD-9-CM and CPT codes. Surgical route was classified into four groups: total abdominal hysterectomy (TAH), total vaginal hysterectomy (TVH), laparoscopic assisted vaginal hysterectomy (LAVH), and total laparoscopic hysterectomy (TLH) including both conventional and robotically assisted. Patients were then stratified according to BMI. Results. 7199 records were included in the study. TLH was the most commonly performed route of hysterectomy regardless of BMI, with proportions of 50.9%, 48.9%, 50.4%, and 51.2% in ideal, overweight, obese, and morbidly obese patients, respectively. The median operative time for TAH was 2.2 hours compared to 2.7 hours for TLH (p < 0.01). The median length of stay for TAH was 3 days compared to 1 day for TLH (p < 0.01). The percentage of patients with an adverse outcome (composite indicator including transfusion, deep venous thrombosis, and infection) was 17.1 versus 3.7 for TAH and TLH, respectively (p < 0.01). Conclusion. During the last decade, TLH has been increasingly performed in women with uterine cancer. The increased adoption of TLH was seen in all BMI subgroups.
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Ara, Sarwat, Umbreen Umbreen, and Fouzia Fouzia. "EMERGENCY OBSTETRIC HYSTERECTOMY." Professional Medical Journal 22, no. 01 (January 10, 2015): 100–105. http://dx.doi.org/10.29309/tpmj/2015.22.01.1417.
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Background: Emergency hysterectomy in obstetric practice is generallyperformed in the setting of life-threatening hemorrhage which fails to be controlled byconservative management. Objective: To review 8 years’ experience of emergency obstetrichysterectomy in a teaching hospital. Study Design: A retrospective descriptive study based onhospital data of 156 patients undergoing emergency Obstetric hysterectomy. Settings: Obs. &Gynae. Department Unit-I, PMC Allied Hospital Faisalabad. Methods: This was a retrospectivereview carried out from March 2004 to Feb 2012 Main outcome measures were frequency,indications, associated risk factors and maternal morbidity and mortality associated withemergency peripartum/obstetric hysterectomy. Results: During 8 years there were total 156(0.38%, 3.8 per 1000) emergency obstetric hysterectomies out of which there were 46 caesarianhysterectomies, 65 post partum, 45 for ruptured uterus with total number of delivery 40062.Number of hysterectomies was 48 in the first 4 years of the study (March 2004- Feb 2008) andduring the last 4 years (March 2008- Feb 2012) it was 108. Maximum obstetric hysterectomieswere in para 3-5 (53.20%) and in 26-30 years age group (35.89%). The most common indicationfor hysterectomy was uterine atony (44.23%) followed by uterine rupture (28.85%), Placentaaccreta (14.745%) and placenta previa (11.53%). The maternal mortality was 6.41% (10patients). In this series 80% patients were referred from other areas. Conclusions: Frequencyof emergency Obstetric hysterectomy is high in our tertiary center and it is continuouslyincreasing due to increased referral of patients. The mortality and morbidity of performingobstetric hysterectomy is higher in patients referred from outside hospital.
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Khabrat, B., O. Lytvak, B. Lysenko, A. Khabrat, and V. Pasko. "Hysterectomy optimization technology in patients with overweight." Клінічна та профілактична медицина 3, no. 13 (November 16, 2020): 22–26. http://dx.doi.org/10.31612/2616-4868.3(13).2020.03.
Full textAbstract:
Aim.
The aim of our work was the development and testing method of hysterectomy, which would greatly facilitate radical hysterectomy in patients who are overweight.
Materials and methods.
In the main group of supervision were included 76 women who had 0 and stage 1 prolapse by POP-Q classification and were operated under minimally invasive surgery of RPCPCM in the period from 2019 to 2020because of uterine fibroids by the method developed by us.The control group consisted of 50 women whom was performed intrafascial hysterectomy by the method of Oldridge. To study the vaginal profile marked by two indicators: the length of the vagina and the range of displacement of the proximal point of the vagina (apex), which were determined before surgery and 24 months after surgery at intervals of one year. Determining the length of the vagina was performed in the supine position, immediately determine the most proximal point of the vagina.
Results and discussion
Conclusions.
Methods of intrafascial hysterectomy using high-frequency diathermy are effective in preventing prolapse stump and shortening of the vagina. Shortening of the vagina in patients in the control group may have been caused by the degenerative processes due to serious injury of support structures and vessels of proximal vagina with the emergence in this context of inflammatory processes in the stump. Shortening of the vagina in patients operated on the proposed method was observed. Trends shortening of the vagina or prolapse at follow-up were found.
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Dermenzhy, T., V. Svintitskiy, S. Nespryadko, L. Legerda, E. Stahovsky, A. Iatsyna, and A. Kabanov. "Nerve-sparing radical hysterectomy in patients with infiltrative cervical cancer." HEALTH OF WOMAN, no. 6(112) (July 29, 2016): 46–51. http://dx.doi.org/10.15574/hw.2016.112.46.
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The objective: to improve an effectiveness of therapy and quality of life of patients with infiltrative cervical cancer using radical hysterectomy accomplished with nerve-sparing methodology. Patients and Methods: Ninety patients with histologically verified infiltrative cervical cancer were cured with radical hysterectomy (RHE) in the Department of Oncogynecology of National Cancer Institute (Kyiv, Ukraine) in 2012-2016. The age of the patients was from 26 to 65 years (an average age of 42.61±1.06). The patients were distributed in 2 groups: group I treated with nerve-sparing radical hysterectomy (NSRHE), 45 patients, the main group; group II treated with radical hysterectomy (RHE III), the control group, 45 patients. The prognostic indexes in the groups were similar. Results. NSRHE that included the dissection of cardinal ligament, separation of dorsal and anterior layers of uterovesical ligament allowed separate uterine branch of inferior hypogastric plexus, preserve an innervation of urinary bladder and prevent the malfunction of its contractile function at postoperative period. Conclusion. The data of the urodynamic study using cystomanometry performed at pre- and early operative periods have shown that surgical treatment of patients with infiltrative cervical cancer with preservation of the major elements of pelvic autonomic plexuses allows significantly decrease the rate of postoperative urogenical malfunctions. Key words: nerve-sparing radical hysterectomy, cervical cancer, cystomanometry.
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Briedite, Ieva, Gunta Ancane, Irena Rogovska, and Nellija Lietuviete. "Quality of Female Sexual Function After Conventional Abdominal Hysterectomy - Three Month' Observation." Acta Chirurgica Latviensis 14, no. 1 (November 24, 2014): 26–31. http://dx.doi.org/10.2478/chilat-2014-0105.
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Summary Introduction. Many medical and conservative surgical treatment options are available but still hysterectomy remains the most common gynecological procedure performed worldwide. These procedures are performed because of actual and possible malignant diseases, and benign conditions including pelvic pain, dyspareunia, uterine myomas, adenomyosis, endometriosis, and menometrorrhagia. The impact of hysterectomy on sexual function has always been a great concern to women and is a major source of preoperative anxiety. Data regarding the impact of hysterectomy on women's sexual functioning are not clear and consistent, many women report improvement of sexual functioning after hysterectomy, which may be due to relief of symptoms, while others complain of sexual dysfunction as a result of hysterectomy. Also discussion about advantages of cervix sparing operations is still controversial. Aim of the study. Aim was to assess and compare pre- and post-operative quality of sexual life of gynecological patients undergoing planned hysterectomy, and to find out opinions of patients and their partners about expected impact of operation and changes after surgery. Material and methods. Questionnaire method was used to survey gynecologic patients undergoing planned subtotal / total hysterectomy due to benign indication. Sexual Quality of Life Questionnaire – Female (SQoL-F) was used to assess quality of sexual life before and after surgery. Questions about other influencing factors and patients' opinions before and after operation were added. 38 completed questionnaires were used for data analysis. Results. Only 55% of subtotal hysterectomy group and 38.9% of total hysterectomy group told their partners completely about planned surgery. Mean period of beginning sexual activities after operation was 5.15 weeks after surgery in subtotal hysterectomy and 5.78 weeks in total hysterectomy group. SQoL-F after three months post-operation period was 6.50 points less in total hysterectomy group, which was not statistically significant. There was a slight statistically insignificant decrease of SQoL-F points within each group after three months observation period: -0.44 points in subtotal hysterectomy group and -2.47 points in total hysterectomy group. Although patients of total hysterectomy more frequently (22.2% vs. 5%) indicated negative impact on sexual function after operation, differences were not statistically significant. There were no differences in co-morbidities, concomitant medications, hormone use history and post-operative complications between groups. Conclusions. Patients before hysterectomy are worried about possible negative impact of surgery on their sexual function, they do not talk to their partners candidly about planned surgery. There were no statistically significant changes of sexual quality of life found after subtotal and total abdominal hysterectomy operation after three months observation period.
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Fathepuriya, Dharmendra Singh, Leena Verma, and Seema Sharma. "Clinico–pathological study of hysterectomy in benign lesions: a study of 379 hysterectomies." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 3 (February 19, 2017): 934. http://dx.doi.org/10.18203/2320-1770.ijrcog20170559.
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Background: Uterus is a very vital reproductive organ and is subjected to many benign and malignant diseases. Hysterectomy is one of the most frequently performed procedures all over the world. Aims and Objectives of the work was to study the clinical benign indications of hysterectomy specimens and to correlate the findings with the histopathological reports.Methods: A prospective and randomized study was performed in 379 cases of elective hysterectomies for benign lesions.Results: Abdominal hysterectomy was performed in 64.6% cases while vaginal hysterectomy accounted for 35.3% cases. The mean age for hysterectomy was 45 years with a range from 14 to 78 years. Patients mostly presented with menstrual irregularities (34.3%) followed by prolapse uterus (30%). The principle indication of elective hysterectomy was leiomyoma and was present in 197(51.9%) patients, followed by prolapse uterus in 134 (35.3%) and dysfunctional uterine bleeding (DUB) in 26 (6.8%) patients. Maximum numbers of cases of leiomyoma, uterine prolapse and DUB were found in age group of 41-50 yrs.Conclusions: The number of abdominal hysterectomy was more than vaginal hysterectomy. Most common presenting feature was menstrual related symptom followed by prolapsed. The main indication for elective hysterectomy was leiomyoma, prolapsed and DUB.
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Labib, M., S. Palfrey, E. Paniagua, and R. Callender. "The Postoperative Inflammatory Response to Injury following Laparoscopic Assisted Vaginal Hysterectomy versus Abdominal Hysterectomy." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 34, no. 5 (September 1997): 543–45. http://dx.doi.org/10.1177/000456329703400509.
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The magnitude of the inflammatory response to surgery depends on the degree of injury during surgical procedures. Laparoscopic techniques are generally associated with less postoperative pain and shorter hospital stay compared with open procedures, presumably due to less tissue injury and reduced inflammatory response. However, no study has been done, to our knowledge, to assess the inflammatory response to surgical trauma following laparoscopic assisted vaginal hysterectomy. We have, therefore, compared the magnitude of the inflammatory response to injury after laparoscopically assisted vaginal hysterectomy (11 patients) and abdominal hysterectomy (11 patients) by measuring serum C-reactive protein (CRP) and interleukin-6 (IL-6) on admission, and at 24 and 48 hours after the operation. Postoperatively, serum CRP rose significantly in both groups but levels in patients who underwent laparoscopically assisted vaginal hysterectomy were significantly lower than in those who underwent abdominal hysterectomy. Serum IL-6 rose significantly after abdominal hysterectomy but not after laparoscopically assisted vaginal hysterectomy. Our results show that the inflammatory response to surgical trauma was significantly less after laparoscopically assisted vaginal hysterectomy than after abdominal hysterectomy confirming that the laparoscopic procedure causes less tissue damage than the abdominal procedure.
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Rana, Jyoti, Shi Hui Rong, and Suersh Mehata. "Retention of Urine After Radical Hysterectomy for Cervical Cancer." Health Prospect 10 (July 22, 2018): 1–4. http://dx.doi.org/10.3126/hprospect.v10i0.5636.
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Background: Radical hysterectomy is the main treatment for cervical cancer. But must of the patients suffered from postoperative bladder dysfunction, such as retention of urine. Objective: To evaluate the retention of urine after radical hysterectomy for cervical cancer in the patients up to stages IA to IIB. Methodology: A cross sectional control study was conducted in the patients diagnosed with cervical cancer and treated with radical hysterectomy in the department of obstetrics and gynecology, first affiliated hospital, Zhengzhou University, P. R. of China to evaluate the postoperative retention of urine in 90 patients from 2003 to 2006. Result and Conclusion: A total of 90 patients with cervical cancer, who underwent radical hysterectomy were included in this study. 25 patients, i.e. 27.8% were menopausal and 11 patients, i.e. 12.2% had blood loss more than 500ml. The patients with retention of urine after radical hysterectomy was compared in relation with loss of blood volume intra- operatively, parity, and menopause; as the possible causes of retention of urine. The overall frequency of retention of urine among the patients who underwent radical hysterectomy for the cervical cancer was 42.2%. The statistical analysis showed that the relation of urine after radical hysterectomy for cervical cancer with loss of blood volume, parity and menopause was found to be nonsignificant. So, retention of urine after radical hysterectomy for cervical cancer might be related to the operative procedure which effects partial sympathetic and parasympathetic denervation during a radical dissection. DOI: http://dx.doi.org/10.3126/hprospect.v10i0.5636Health Prospect Vol.10 2011, pp.1-4
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Patne, Smita S., Aditi J. Upadhye, and Jayshree J. Upadhye. "Analysis of indications and route of hysterectomy for benign conditions." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 6 (May 26, 2018): 2347. http://dx.doi.org/10.18203/2320-1770.ijrcog20182347.
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Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. The primary focus of this study was to review the indications and surgical technique of hysterectomy.Methods: This retrospective study was performed in the department of Obstetrics and gynecology, in collaboration with Department of Pathology. All women in the reproductive age group and post-menopausal age who underwent hysterectomy with or without salpingo-oophorectomy were included in this study.Results: In our study, out of 100 patients, clinical indication was fibroid in 45 (45%) patients, menorrhagia in 15 (15%) patients, adenomyosis in 25 (25%) patients, uterovaginal prolapse in 5 (5%) patients, endometrial polyp in 5 (5%) patients and ovarian tumor in 5 (5%) patients. Histo-pathological diagnosis was leiomyoma in 55 (55%), adenomyosis in 30 (30%), endometrial polyp in 5 (5%), endometrial hyperplasia in 5 (5%) and serous cystadenoma of ovary in 5 (5%). Abdominal hysterectomy was performed in 46 (46%) patients, vaginal hysterectomy in 44 (44.33%) patients while laparoscopic hysterectomy was performed in 5 (6.66%) patients.Conclusions: In this study, most common indication for hysterectomy was fibroid uterus and it was correlated well with histopathology. Abdominal & vaginal hysterectomies were performed in almost equal number.
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Yoo, Ji Geun, Yoon Kyung Elena Lee, and Keun Ho Lee. "Surgical outcomes of single port lapraroscopic radical hysterectomy in cervical cancer." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e17003-e17003. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e17003.
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e17003 Background: We aim to see the postoperative outcomes of single port laparoscopic radical hysterectomy in cervical cancer. Methods: Twenty five cervical cancer patients (FIGO stage 9 IA, 13 IB, and 3 IIA) were treated by single port laparoscopic radical hysterectomy in single center. Results: Six patients were performed by type A hysterectomy, 6 by type B, and 13 by type C radical hysterectomy. Median operation time was 91, 197, and 275 minutes, respectively. Median number of pelvic nodes retrieved was 20. There was no postoperative complication except a colon serosa injury in type C radical hysterectomy and which repaired by single port approach. Ten out of 25 patients got an adjuvant radiation therapy and there were 3 recurrences (1 in type A, 2 in type C). Median disease free survival was 9.5 months in type A, 14 months in type C. Conclusions: Single port radical hysterectomy is safe and comparable to conventional laparoscopic hysterectomy in cervical cancer
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Patel, Tejal L., Rinkal R. Patel, and Vaibhavi Vaghela. "Comparative study of non-descent vaginal hysterectomy with abdominal hysterectomy." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 1 (December 26, 2018): 308. http://dx.doi.org/10.18203/2320-1770.ijrcog20185445.
Full textAbstract:
Background: Hysterectomy is one of the most common operation performed in Obstetrics and Gynecology next to caesarean section. Due to its advantages vaginal hysterectomy are more and more performed now. Only drawback is lack of expertise. Present study focuses on comparison between outcomes in abdominal versus vaginal hysterectomy and to determine which route of hysterectomy is superior, safer and effective.Methods: The study is a prospective study conducted in the department of obstetrics and Gynecology. Civil hospital, Ahmedabad between the period of Jan 2016 to 2017. Of 100 patients. Fifty patients who underwent hysterectomy by vaginal route are taken as study group A, and the remaining 50 patients who underwent by the abdominal route are taken as study group B.Results: Majority of women undergoing hysterectomy were in age group of 30-50 years; postmenopausal age group women were less;13 NDVH and 5 in AH. Majority of the women were multipara in both age groups. Menorrhagia was found to be major indication with 42 in NDVH and 40 in AH. There is much significant difference in the postoperative pain in both groups with less in NDVH group. There is not much significant difference in blood loss in both the groups. Postoperative complications were more with AH.Conclusions: Thus, it can be concluded that NDVH is feasible, safe and provide more patient comfort without increasing the duration of surgery and other post-operative complications.
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Chen, Lichun, Baohua Wu, Qing Han, and Jianying Yan. "Clinical analysis of emergency exploratory laparotomy in patients with intractable postpartum hemorrhage." Journal of International Medical Research 48, no. 2 (October 29, 2019): 030006051987929. http://dx.doi.org/10.1177/0300060519879294.
Full textAbstract:
Objective This study was performed to explore the causes and clinical characteristics of emergency exploratory laparotomy in patients with intractable postpartum hemorrhage. Methods This retrospective study was performed from January 2004 to December 2017. Patients with intractable postpartum hemorrhage were grouped according to the initial pathogenesis as determined by exploratory laparotomy: uterine atony, placental factors, coagulation dysfunction, or uterine rupture. Results This study involved 72 patients who underwent emergency exploratory laparotomy, accounting for 0.04% of total deliveries. Uterine preservation surgery and hysterectomy were performed in 31 and 41 patients, respectively. Abnormal events upon returning to the ward were primarily vaginal hemorrhage and pelvic hematoma. The frequency of uterine artery ligation was lower in the hysterectomy group than uterine preservation group. The prothrombin activity level, fibrinogen level, and platelet count before surgery were lower in the hysterectomy group than uterine preservation group. The international normalized ratio and activated partial thromboplastin time were higher in the hysterectomy group than uterine preservation group. In total, 44 patients developed complications. Conclusion Placental implantation is a primary cause of hysterectomy after emergency laparotomy. However, the possibility of postpartum hemorrhage caused by coagulation disorders should not be ignored.
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Djurdjevic, Srdjan, Aleksandra Vejnovic, and Milos Pantelic. "Laparoscopic assisted vaginal hysterectomy at the clinic of gynecology and obstetrics in Novi Sad." Medical review 72, no. 5-6 (2019): 143–47. http://dx.doi.org/10.2298/mpns1906143d.
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Introduction. Laparoscopic assisted vaginal hysterectomy is a surgical procedure with uterine artery ligation followed by vaginal removal of the uterus. The first laparoscopic assisted vaginal hysterectomy was performed by Harry Reich in 1989. Material and Methods. The sample included 24 patients who underwent surgery at the Clinic of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad in the period 2014 - 2017. The most common indications for laparoscopic assisted vaginal hysterectomy included mild uterine prolapse and uterine fibroids (15 patients, 62.5%). The surgery was carried out in two stages: the first, laparoscopic stage and the second, vaginal stage. The laparoscopic stage included mobilization of the bladder, ovaries and uterus to the level of uterine vessels. In the second stage, the cervix was approached vaginally and detached from the urinary bladder, after which the uterus with cervix and adnexa were removed through the vagina. Results. The average age of patients was 56.8 years; on average, the surgeries lasted 140 minutes and the mean blood loss was 190 ml. Two (8.3%) patients experienced bladder and ureteral injuries which were resolved by urologists. Laparoscopic assisted vaginal hysterectomy was the only procedure performed in 5 (20.8%) patients, whereas it was combined with anterior and/or posterior colporrhaphy in 14 (58.4%), with pelvic lymphadenectomy in 3 (12.5%) patients, and with uterine morcellation in 2 (8.3%) patients. Conclusion. There are no published controlled trials related to the use of laparoscopic assisted vaginal hysterectomy and total laparoscopic hysterectomy in Serbia. This paper presents the preliminary results of the laparoscopic assisted vaginal hysterectomy in 24 patients, comparing them with other techniques of hysterectomy conducted at the Clinic of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad in the period 2014 - 2017. Laparoscopic assisted vaginal hysterectomy is a good option for surgical treatment of patient with combined pathology of genital organs.
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Wright, Jason D., William M. Burke, Ana I. Tergas, June Y. Hou, Yongmei Huang, Jim C. Hu, Grace Clarke Hillyer, Cande V. Ananth, Alfred I. Neugut, and Dawn L. Hershman. "Comparative Effectiveness of Minimally Invasive Hysterectomy for Endometrial Cancer." Journal of Clinical Oncology 34, no. 10 (April 1, 2016): 1087–96. http://dx.doi.org/10.1200/jco.2015.65.3212.
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Purpose Despite the potential benefits of minimally invasive hysterectomy for uterine cancer, population-level data describing the procedure’s safety in unselected patients are lacking. We examined the use of minimally invasive surgery and the association between the route of the procedure and long-term survival. Methods We used the SEER-Medicare database to identify women with stage I-III uterine cancer who underwent hysterectomy from 2006 to 2011. Patients who underwent abdominal hysterectomy were compared with those who had minimally invasive hysterectomy (laparoscopic and robot-assisted). Perioperative morbidity, use of adjuvant therapy, and long-term survival were examined after propensity score balancing. Results We identified 6,304 patients, including 4,139 (65.7%) who underwent abdominal hysterectomy and 2,165 (34.3%) who underwent minimally invasive hysterectomy; performance of minimally invasive hysterectomy increased from 9.3% in 2006 to 61.7% in 2011. Robot-assisted procedures accounted for 62.3% of the minimally invasive operations. Compared with women who underwent abdominal hysterectomy, minimally invasive hysterectomy was associated with a lower overall complication rate (22.7% v 39.7%; P < .001), and lower perioperative mortality (0.6% v 1.1%), but these women were more likely to receive adjuvant pelvic radiotherapy (34.3% v 31.3%) and brachytherapy (33.6% v 31.0%; P < .05). The complication rate was higher after robot-assisted hysterectomy compared with laparoscopic hysterectomy (23.7% v 19.5%; P = .03). There was no association between the use of minimally invasive hysterectomy and either overall (HR, 0.89; 95% CI, 0.75 to 1.04) or cancer-specific (HR, 0.83; 95% CI, 0.59 to 1.16) mortality. Conclusion Minimally invasive hysterectomy does not appear to compromise long-term survival for women with endometrial cancer.
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Abrol, Shivani, Shazia Rashid, Farhat Jabeen, and Shiveta Kaul. "Comparative analysis of non-descent vaginal hysterectomy versus total abdominal hysterectomy in benign uterine disorders." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 3 (February 19, 2017): 846. http://dx.doi.org/10.18203/2320-1770.ijrcog20170472.
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Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. Currently, there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descent uterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating time, intraoperative and postoperative complications between VH and TAH in non-descent uterus.Methods: The study was conducted in the Postgraduate department of Gynaecology and Obstetrics for a period of 18 months between April 2013 to October 2014 in the Government Lalla Ded Hospital - an associated hospital of Government Medical College, Srinagar; which is the sole tertiary care referral centre in the valley.Results: Over the study period 100 patients were taken, 50 patients underwent non-descent vaginal hysterectomy and labelled as group A and 50 patients were under went total abdominal hysterectomy and labelled as group B. It was seen that intraoperative complications and postoperative complications were less in group A patients and operating time is also less with group A patients when compared with group B patients.Conclusions: From the present study, it was concluded that NDVH is associated with less blood loss during surgery, quicker recovery, and early mobilization, less operative and less postoperative morbidity when compared to TAH. NDVH is a less invasive technique with shorter hospital stay and faster convalescence.
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Carvalho, Jesus Paula, Jorge Saad Souen, Silvia da Silva Carramão, Wang Lee Yeu, and José Aristodemo Pinotti. "Wertheim-Meigs radical hysterectomy." Sao Paulo Medical Journal 112, no. 2 (June 1994): 539–42. http://dx.doi.org/10.1590/s1516-31801994000200003.
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Wertheim-Meigs hysterectomy is the treatment of choice for invasive cervix cancer stage IB and IIA at the University of São Paulo Medical School. It was performed in 168 patients between 1974 and 1993. Pelvic lymph node metastases were found in 19 patients (11.3%) and 149 were negative lymph node. The recurrence rate was 21% in the positive lymph node and 6% in the negative lymph node patients. Complications occurred in 35 patients (20.83%) and were as follows: atonic bladder in 9.52%; fistulae in 5.59%; urinary incontinence in 4.76%; ureteral stenosis in 2.97%; dehiscence in 2.38% and lymphedema in 1.19%. Intraoperative complications occurred at a rate of 4.76% and involved injuries to the bladder, ureter and great vessels.
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Shah, Neel T., Kelly N. Wright, Gudrun M. Jonsdottir, Selena Jorgensen, Jon I. Einarsson, and Michael G. Muto. "The Feasibility of Societal Cost Equivalence between Robotic Hysterectomy and Alternate Hysterectomy Methods for Endometrial Cancer." Obstetrics and Gynecology International 2011 (2011): 1–9. http://dx.doi.org/10.1155/2011/570464.
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Objectives. We assess whether it is feasible for robotic hysterectomy for endometrial cancer to be less expensive to society than traditional laparoscopic hysterectomy or abdominal hysterectomy.Methods. We performed a retrospective cohort analysis of patient characteristics, operative times, complications, and hospital charges from all () endometrial cancer patients who underwent hysterectomy in 2009 at our hospital. Per patient costs of each hysterectomy method were examined from the societal perspective. Sensitivity analysis and Monte Carlo simulation were performed using a cost-minimization model.Results. 40 (17.1%) of hysterectomies for endometrial cancer were robotic, 91 (38.9%), were abdominal, and 103 (44.0%) were laparoscopic. 96.3% of the variation in operative cost between patients was predicted by operative time (, ). Mean operative time for robotic hysterectomy was significantly longer than other methods (). Abdominal hysterectomy was consistently the most expensive while the traditional laparoscopic approach was consistently least expensive. The threshold in operative time that makes robotic hysterectomy cost equivalent to the abdominal approach is within the range of our experience.Conclusion. It is feasible for robotic hysterectomy to be less expensive than abdominal hysterectomy, but unlikely for robotic hysterectomy to be less expensive than traditional laparoscopy.
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Marra, Alexandre R., Mireia Puig-Asensio, Michael B. Edmond, Marin L. Schweizer, and David Bender. "Infectious complications of laparoscopic and robotic hysterectomy: a systematic literature review and meta-analysis." International Journal of Gynecologic Cancer 29, no. 3 (March 2019): 518–30. http://dx.doi.org/10.1136/ijgc-2018-000098.
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ObjectiveWe performed a systematic review of the literature and meta-analysis of the infectious complications of hysterectomy, comparing robotic-assisted hysterectomy to conventional laparoscopic-assisted hysterectomy.MethodsWe searched PubMed, CINAHL, CDSR, and EMBASE through July 2018 for studies evaluating robotic-assisted hysterectomy, laparoscopic-assisted hysterectomy, and infectious complications. We employed random-effect models to obtain pooled OR estimates. Heterogeneity was evaluated with I2 estimation and the Cochran Q statistic. Pooled ORs were calculated separately based on the reason for hysterectomy (eg, benign uterine diseases, endometrial cancer, and cervical cancer).ResultsFifty studies were included in the final review for the meta-analysis with 176 016 patients undergoing hysterectomy. There was no statistically significant difference in the number of infectious complication events between robotic-assisted hysterectomy and laparoscopic-assisted hysterectomy (pooled OR 0.97; 95 % CI 0.74 to 1.28). When we performed a stratified analysis, similar results were found with no statistically significant difference in infectious complications comparing robotic-assisted hysterectomy to laparoscopic-assisted hysterectomy among patients with benign uterine disease (pooled OR 1.10; 95 % CI 0.70 to 1.73), endometrial cancer (pooled OR 0.97; 95 % CI 0.55 to 1.73), or cervical cancer (pooled OR 1.09; 95 % CI 0.60 to 1.97).ConclusionIn our meta-analysis the rate of infectious complications associated with robotic-assisted hysterectomy was no different than that associated with conventional laparoscopic-assisted hysterectomy.
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Djordjevic, Biljana, Zorica Stanojevic, Vesna Zivkovic, Dusan Lalosevic, Jasmina Gligorijevic, and Miljan Krstic. "Preoperative and postoperative histopathological findings in patients with endometrial hyperplasia." Medical review 60, no. 7-8 (2007): 372–76. http://dx.doi.org/10.2298/mpns0708372d.
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Introduction. The aim of this study was to analyze and compare the histopathological findings in curettage and hysterectomy specimens, to evaluate the accuracy of histopathological diagnosis in curettage specimens, and to determine the frequency of coexisting endometrial carcinoma in patients with histopathological diagnosis of endometrial hyperplasia. Material and methods. Curettage and hysterectomy specimens of 135 female patients with initially diagnosed endometrial hyperplasia were retrospectively analyzed and compared. Results. Simple hyperplasia was found in 49 patients (36.3%), complex hyperplasia in 14 (10.4%), simple atypical hyperplasia in 24 (17.8%), and complex atypical hyperplasia in 48 (35.5%) patients. After hysterectomy, 59 (43.7%) patients were found to have simple hyperplasia, 12 (8.9%) complex hyperplasia, 15 (11.1%) simple atypical hyperplasia, 18 (20.7%) complex atypical hyperplasia, and 21 (15.5%) endometrial carcinoma. The accuracy of histopathological diagnosis of endometrial hyperplasia in curettage specimens was 82.2-89.6% and dependent on the types of hyperplasia. The frequency of coexisting endometrial carcinoma was significantly higher (p<0.001) in patients with atypical hyperplasia than in patients with hyperplasia without cytological atypia. After hysterectomy, coexisting endometrial carcinoma was found in 27.8% of patients with histopathological diagnosis of atypical hyperplasia in curettage specimens. In contrast to simple atypical hyperplasia, the frequency of coexisting endometrial carcinoma was significantly higher (p<0.05) in complex atypical hyperplasia. Conclusion. The frequency of coexisting endometrial carcinoma in hysterectomy specimens in patients with histopathological diagnosis of atypical hyperplasia in curettage specimens was relatively high and it should be taken into account when planning therapy. .
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Maiti, G. D., Ashok Pillai, Tony Jose, and P. R. Lele. "Non-descent vaginal hysterectomy in women with previous caesarean section scar: our experience." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 6 (May 26, 2018): 2404. http://dx.doi.org/10.18203/2320-1770.ijrcog20182358.
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Background: Hysterectomy is one of the common gynaecological major surgeries performed worldwide. In spite of technological advancement with laparoscopic and robotic hysterectomy conventional hysterectomy through vaginal route of nonprolapse uterus popularly known as, Non-Descent Vaginal Hysterectomy (NDVH) remains a justifiable cost effective, cosmetically appealing option especially in resource-crunched developing country. NDVH in post caesarean scarred uterus too a technically challenged procedure requiring skills and expertise.Assessment of technical feasibility and safety of non-descent vaginal hysterectomy in women with previous caesarean section scar were studied.Methods: The study was a prospective observational study of 72 patients with LSCS scar requiring hysterectomy for benign conditions were selected based on the inclusion and exclusion criteria carried out from June 2012 to May 2017. Operating time, blood loss, surgical techniques, intra/postoperative challenges, conversion to laparotomy or laparoscopic assistance and length of hospital stay were recorded for each case. Patients were followed up till 03 months of surgery.Results: Vaginal hysterectomy was successful in all cases. Morcellation, bisection or myomectomy, were done in 86% cases. Two patients had bladder injury, which was repaired vaginally, two cases required support of laparoscopy. No patients needed blood transfusion. None of the patients were converted to laparotomy.Conclusions: Vaginal hysterectomy is a safe and effective procedure for benign non-prolapsed uteri in women with previous caesarean section scar when uterine size is less than 14 weeks. Standby operating laparoscopy provides added advantages to surgeon in doubtful or difficult cases to avoid conversion laparotomy.
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Flores-Mendoza, H., CA Hernandez-Nieto, D. Basurto-Diaz, and LF Garcia-Rodriguez. "A Comparison of In-Hospital Stay Length in Patients Undergoing Minimally Invasive Hysterectomy: Total Laparoscopic Hysterectomy vs. Vaginal Hysterectomy." Journal of Minimally Invasive Gynecology 23, no. 7 (November 2016): S215. http://dx.doi.org/10.1016/j.jmig.2016.08.715.
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Carbonnel, M., H. Abbou, H. T. N’Guyen, S. Roy, G. Hamdi, A. Jnifen, and J. M. Ayoubi. "Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study." Minimally Invasive Surgery 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/429105.
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Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus min; ). Blood loss and length of hospital stay were significantly reduced: versus ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.