AI Article Synopsis
- The study aims to establish criteria for laparoscopically assisted vaginal hysterectomy (LAVH) based on a statistical analysis of surgical outcomes over a 15-year period at a hospital, focusing on patients with uterine fibroids and adenomyosis.
- Researchers analyzed the medical records of 629 patients and compared surgical results like blood loss and complications across different groups based on uterine weight.
- Results indicated that LAVH is more appropriate for patients with a uterine weight less than 800g (around 12 cm), as higher weights are associated with increased risks of complications and blood loss, suggesting that total abdominal hysterectomy (TAH) is a safer option for heavier uteri.
Article Abstract
Objectives: Total hysterectomy procedures include total abdominal hysterectomy (TAH), total vaginal hysterectomy (TVH), and laparoscopically assisted vaginal hysterectomy (LAVH). Our institution has introduced LAVH as a preferred option to the more invasive TAH. To date, no reports have proposed surgical indications for LAVH based on statistical analysis of surgical results. The purpose of this study was to establish criteria for performing LAVH through statistical analysis of a retrospective review of surgical outcomes in LAVH cases at our institution over a period of 15 years.
Methods: The medical records of 629 patients scheduled for LAVH for uterine fibroids and/or adenomyosis at our hospital were examined. Surgical results (blood loss, operative time, rates of conversion to laparotomy, and intraand postoperative complications) were compared among 9 groups classified by uterine weight.
Results: Statistically significant differences in surgical outcomes were found between the group with a uterine weight ≥ 800g and the other groups.
Conclusion: We found that when the uterine weight was ≥ 800g, TAH was more appropriate because significant blood loss and/or complications would be expected during LAVH. A removed uterus weighing 800g is reportedly equivalent to a preoperative uterine size of approximately 12 cm. Therefore, LAVH may be safely indicated for patients with a uterine size ≤ 12 cm (approximately equivalent to the uterine size at 16-weeks gestation).
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183566 | PMC |
| http://dx.doi.org/10.4293/108680811X13125733357151 | DOI Listing |
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