Purpose: To compare the antecedent gynecological characteristics, indications for, and complications associated with, the different laparoscopic approaches to hysterectomy, in women with benign gynecological conditions.
Methods: A retrospective cohort study of 957 patients who underwent laparoscopic supracervical (LSH), total (TLH), and assisted vaginal (LAVH) hysterectomies between January 2003 and December 2009.
Results: Among 957 LH, 799 (83.5%) were LSH, 62 (6.4%) TLH, and 96 (10.1%) LAVH. Demographic characteristics were not different among the groups. Antecedent gynecologic conditions that were associated with the type of laparoscopic hysterectomy (LH) performed were: postmenopausal bleeding [LAVH vs. LSH, odds ratio (OR) 2.20; 95% confidence interval (CI) 1.04-4.65], previous pelvic surgery (TLH vs. LSH, OR 1.92; CI 1.05-3.52), previous cesarean delivery (LAVH vs. LSH, OR 0.39; CI 0.21-0.76), and prior hysteroscopy (LAVH vs. LSH, OR 0.29; CI 0.16-0.50). Preoperative diagnoses that were associated with the choice of LH were: menometrorrhagia (LAVH vs. LSH, OR 0.23; CI 0.14-0.38; TLH vs. LSH, OR 0.50; CI 0.26-0.98), uterine fibroids (LAVH vs. LSH, OR 0.25; CI 0.15-0.41), endometrial hyperplasia (TLH vs. LSH, OR 5.5; CI 2.04-14.84), and cervical dysplasia (TLH vs. LSH, OR 17.1; CI 6.83-42.79; LAVH vs. LSH, OR 8.05; CI 3.05-22.06). Estimated blood loss, operating time, and length of hospital stay were significantly reduced with LSH.
Conclusion: Antecedent gynecological history and the indications for surgery were associated with the type of LH performed in our institution. LSH was the most common approach and was associated with significantly less morbidity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00404-011-2140-2 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Objectives To assess the differences in demographics and laparoscopic hysterectomy type by comorbid obesity and to assess the risk of in-hospital mortality due to obesity and other comorbidities. Methods We conducted a cross-sectional study using the Nationwide Inpatient Sample (NIS, 2012-2014), and included 119,890 adult females undergoing total laparoscopic hysterectomy (TLH), laparoscopic-assisted vaginal hysterectomy (LAVH), and laparoscopic supracervical hysterectomy (LSH). We used a logistic regression model adjusted for confounders to assess the odds ratio (OR) of obesity on mortality in study inpatients.
View Article and Find Full Text PDFSingle-port laparoscopic hysterectomy for uteri greater than 500 grams.
Taiwan J Obstet Gynecol
July 2020
Department of Obstetrics and Gynecology, Hsin-Chu Br, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Objectives: To study the operative outcomes of single-port laparoscopic hysterectomy in uteri greater than 500 g, using either laparoscopic assisted vaginal hysterectomy (LAVH) or laparoscopic supracervical hysterectomy (LSH).
Materials And Methods: 78 patients were included in a single institute by a single surgeon from March, 2013 to January, 2018.
Results: The median uterine weight was 686.
Inpatient Laparoscopic Hysterectomy in the United States: Trends and Factors Associated With Approach Selection.
J Minim Invasive Gynecol
January 2017
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT.
Study Objective: To examine utilization patterns of different laparoscopic approaches in inpatient hysterectomy and identify patient and hospital characteristics associated with the selection of specific laparoscopic approaches.
Design: Using data from the 2007 to 2012 National (Nationwide) Inpatient Sample (NIS), we identified adult women undergoing inpatient laparoscopic hysterectomy for nonobstetric indications based on International Classification of Diseases, Ninth Revision, Clinical Modification codes. Benign cases were categorized based on laparoscopic approach, classified as total laparoscopic hysterectomy (TLH), laparoscopic-assisted vaginal hysterectomy (LAVH), or laparoscopic supracervical hysterectomy (LSH).
Background And Objective: Despite the prevalence of hysterectomy for treatment of benign gynecologic conditions, providers nationwide have been slow to adopt minimally-invasive surgical techniques. Our objective is to investigate the impact of a department for minimally invasive gynecologic surgery (MIGS) on the rate of laparoscopic hysterectomy at an academic community hospital without robotic technology.
Methods: This retrospective observational study included all patients who underwent hysterectomy for benign indications from January 1, 2004, through December 31, 2012.
The incidence of complications by hysterectomy for benign disease in correlation to an assumed preoperative score.
Arch Gynecol Obstet
July 2015
Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, Haus 24, 24105, Kiel, Germany,
Background: Hysterectomies are preformed abdominally, vaginally, laparoscopic or with robotic assistance. When choosing the route of hysterectomy, the physician should take into consideration the safest and most cost-effective route to fulfill all needs of the patient.
Methods: Data were collected retrospectively from 953 patients who underwent hysterectomy between 2002 and 2010 for benign indications at UKSH, Germany.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!