Risk of Bowel Obstruction After Hysterectomy for Benign Indication According to Surgical Method in Denmark, 1984-2013.

Study Objective: To estimate the risk of bowel obstruction (BO) after hysterectomy for benign indications depending on the surgical method (abdominal, vaginal, or laparoscopic) and identify risk factors for adhesive BO.

Design: A national registry-based cohort.

Setting: Danish hospitals during the period 1984-2013.

An autologous blood-derived patch as a hemostatic agent: evidence from thromboelastography experiments and a porcine liver punch biopsy model.

Perioperative bleeding is a common complication in surgeries that increases morbidity, risk of mortality, and leads to increased socioeconomic costs. In this study we investigated a blood-derived autologous combined leukocyte, platelet, and fibrin patch as a new means of activating coagulation and maintaining hemostasis in a surgical setting. We evaluated the effects of an extract derived from the patch on the clotting of human blood in vitro, using thromboelastography (TEG).

Long-Term Health Consequences After Ovarian Removal at Benign Hysterectomy : A Nationwide Cohort Study.

Background: More evidence is needed to substantiate current recommendations about removing ovaries during hysterectomy for benign conditions.

Objective: To compare long-term outcomes in women with and without bilateral salpingo-oophorectomy (BSO) during hysterectomy for benign conditions.

Design: Emulated target trial using data from a population-based cohort.

Ovarian removal and subsequent breast cancer prognosis: a nationwide cohort study.

Purpose: To evaluate whether previous ovarian removal concomitant with benign hysterectomy improves prognosis in a cohort of women with breast cancer.

Methods: In this nationwide register-based cohort study, risk of recurrence and mortality were examined in 4563 women with invasive breast cancer and previous bilateral salpingo-oophorectomy (BSO) concomitant with benign hysterectomy, during 1977-2018. Comparing with benign hysterectomy alone, hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated by Cox-proportional hazards regression models.

Autologous Blood-Derived Patches Used as Anti-adhesives in a Rat Uterine Horn Damage Model.

Background: Intra-abdominal adhesions are frequent side effects of surgery, associated with risks of serious complications such as abdominal pain, infertility, and small bowel obstruction. This study investigated a new autologous blood-based approach to adhesion prophylaxis.

Materials And Method: Two autologous blood-derived patches (whole-blood-derived, n = 20, and plasma-derived, n = 20) were evaluated as anti-adhesives.

Ovarian removal at or after benign hysterectomy and breast cancer: a nationwide cohort study.

Purpose: Large-scale population-based registry studies investigating the risk of breast cancer after removal of both ovaries at hysterectomy for benign conditions in women with no known genetic predisposition to cancer are needed. We aimed to perform such a study taking into account the age at surgery status and use of hormone replacement therapy (HRT).

Methods: Within the female population of Denmark born 1937-1996, we evaluated breast cancer incidence after unilateral or bilateral oophorectomy concomitant with or after benign hysterectomy in comparison with no surgery and with hysterectomy alone using health registry data during 1978-2016.

Adhesive bowel obstruction: Incidence, recurrence and 30-day mortality in Danish women 1984-2013 - A national cohort study.

Background: Adhesive bowel obstruction is a serious complication to abdominal surgery. It is unknown whether incidence and mortality rates have changed as new surgical procedures were introduced.

Methods: In a nationwide cohort of Danish women from 1984 to 2013, incidence of adhesive bowel obstruction and 30 days mortality were presented as standardized rates.

Complications after benign hysterectomy, according to procedure: a population-based prospective cohort study from the Danish hysterectomy database, 2004-2015.

Objective: To compare the risk of complications associated with benign hysterectomy according to surgical procedure.

Design: Register-based prospective cohort study.

Setting: Danish Hysterectomy Database, 2004-2015.

Reduced Complications Following Implementation of Laparoscopic Hysterectomy: A Danish Population-based Cohort Study of Minimally Invasive Benign Gynecologic Surgery between 2004 and 2018.

Study Objective: To monitor and report nationwide changes in the rates of and complications after different methods for benign hysterectomy, operative hysteroscopy, myomectomy, and embolization in Denmark. To report the national mortality after benign hysterectomy DESIGN: National prospective, observational cohort study.

Setting: The Danish Hysterectomy and Hysteroscopy Database.

From prescription to guidance: a European framework for generic competencies.

In postgraduate medical education, required competencies are described in detail in existing competency frameworks. This study proposes an alternative strategy for competency-based medical education design, which is supported by change management theories. We demonstrate the value of allowing room for re-invention and creative adaptation of innovations.

Risk of adhesive bowel obstruction after abdominal surgery. A national cohort study of 665,423 Danish women.

Background: Adhesive bowel obstruction is associated with considerable morbidity and mortality, but the magnitude of the risk is debated.

Method: In a national cohort of all Danish women with an abdominal operation (N = 665,423) between 1977 and 2013, the risk of adhesive bowel obstruction was assessed by Cox multiple regression. Covariates were the number of abdominal operations, the surgical methods, the anatomical site involved, and the calendar year.

Systematic review of the limited evidence for different surgical techniques at benign hysterectomy: A clinical guideline initiated by the Danish Health Authority.

Hysterectomy for benign gynecological conditions is a common operation that has developed extensively through the last 20 years. Methods and surgical techniques vary throughout the regions in Denmark as well as internationally. Consequently, the Danish Health Authority initiated a national clinical guideline on the subject based on a systematic review of the literature.

A systematic review and meta-analysis of the effect of prophylactic tranexamic acid treatment in major benign uterine surgery.

Background: The value of tranexamic acid (TA) treatment as bleeding prophylaxis in major uterine surgery is unclear.

Objectives: To evaluate the antihemorrhagic effect of prophylactic TA treatment in major benign uterine surgery.

Search Strategy: PubMed, Embase, Cochrane Library, and Web of Science were searched from 1980 to 2015 without language restriction using search terms related to major uterine surgery combined with TA.

The Danish Hysterectomy and Hysteroscopy Database.

Aim Of The Database: The steering committee of the Danish Hysterectomy and Hysteroscopy Database (DHHD) has defined the objective of the database: the aim is firstly to reduce complications, readmissions, reoperations; secondly to specify the need for hospitalization after hysterectomy; thirdly to secure quality assessment of hysterectomy and hysteroscopy by setting standards and national guidelines; and finally to intensify the monitoring of laparoscopic surgery and explore long-term side effects after hysterectomy.

Study Population: We include all women in Denmark who have had elective benign uterine surgery since 2003. The surgery includes hysterectomy and operative hysteroscopy.

Anti-hemorrhagic effect of prophylactic tranexamic acid in benign hysterectomy-a double-blinded randomized placebo-controlled trial.

Background: Hysterectomy is one of the most frequently performed major gynecological surgical procedures. Even when the indication for the procedure is benign, relatively high complication rates have been reported. Perioperative bleeding seems to represent the most common cause of complications and in 2004, 8% of all women in Denmark undergoing benign hysterectomy experienced a bleeding complication.

[Spontaneous bilateral tubal pregnancy following caesarean section].

We describe a rare case of bilateral tubal pregnancy following natural conception in a woman with no other known risk factor than two former caesarean sections. Intraabdominal adhesions following the caesarean sections complicated the salpingectomy thus diminishing certainty of a healthy contralateral tube. The woman was readmitted three weeks later and had an additional salpingectomy on behalf of an unrecognized tubal pregnancy.

Use of vaginal hysterectomy in Denmark: rates, indications and patient characteristics.

Objective: To describe the use of vaginal, abdominal and laparoscopic hysterectomy in Denmark from 1999 to 2008, the influence of national guidelines and the patient and procedure-related characteristics associated with the choice of vaginal hysterectomy. Design. Nationwide register-based cohort study.

[Successful training course in academic research in gynaecology and obstetrics].

In 2003 The National Board of Health, Denmark, enforced a compulsory training course in academic research as part of the specialist training for doctors. The trainees must learn to search and evaluate relevant literature and be able to implement the results in clinical practice. The structure of the 20 days of academic training in gynaecology and obstetrics is described.

Hysterectomy, oophorectomy and risk of dementia: a nationwide historical cohort study.

Background: This study aimed to determine whether there is an association between hysterectomy and dementia.

Methods: All female Danish residents born before 1966, alive on their 40th birthday and without a dementia diagnosis prior to 1977 (n = 2,313,388) were followed from January 1, 1977, or the age of 40, whichever came later, until dementia diagnosis, death, emigration or December 31, 2006, whichever came first. The relative risks (RR) for developing dementia in women with hysterectomy/oophorectomy compared to referent women were calculated.

Hypertension is associated with an increased risk for hysterectomy: a Danish cohort study.

Objective: To assess whether hypertension is a risk factor for hysterectomy, endometrial resection, and myomectomy.

Study Design: Self-report questionnaires were collected from 81% of 1959 Danish women aged 30 or 40 years selected at random in 1976-1991, in four different cohort studies. Baseline data included standardized information about cardiovascular diseases, hypertension, use of medicine, gynecologic history, social background, and life style factors.

Hysterectomy on benign indication in Denmark 1988-1998. A register based trend analysis.

Background: The aims of the study were to describe the trends in Danish hysterectomy rates from 1988 to 1998 for operations done on benign indication.

Methods: Data from all women (n=67,096) undergoing hysterectomy from 1988 to 1998 were obtained from the Danish National Patient Register. Data on the female population distribution were obtained from the Danish National Population Register.

[Hypertension and hysterectomy in Danish women].

The aim was to assess whether hypertension is a risk factor for hysterectomy. In a prevalence study, 2301 Danish women were selected at random in 1982. Information about cardiovascular diseases, hypertension, use of medicine, weight history, life-styles, psychological factors, gynaecological history, and social background were obtained.

Hypertension and hysterectomy in Danish women.

Objective: To assess whether hypertension is a risk factor for hysterectomy performed for benign diseases.

Methods: Self-report questionnaires were collected from 77% of 2301 Danish women aged 30, 40, 50, or 60 years selected at random in 1982 for a prevalence study. Information about cardiovascular diseases, hypertension, use of medicine, weight and dieting history, life-styles, psychologic factors, gynecologic history (including history of hysterectomy), and social background were recorded.