AI Article Synopsis
- The study evaluates the feasibility of same-day surgery for minimally invasive hysterectomies performed on women, focusing on factors contributing to success or failure.
- Conducted at Caen and Amiens University Hospitals, it included 50 patients under 70 with no major health issues, categorized into "fit" and "unfit" groups based on their recovery scores.
- The results highlighted that prior laparotomy, pain, and postoperative nausea/vomiting were significant predictors for unsuccessful same-day discharge, but overall, same-day hysterectomy was found to be safe and feasible.
Article Abstract
Objectives: Hysterectomy, one of the most frequent surgical procedures in women, is commonly performed by a minimally-invasive approach (laparoscopic or vaginal) as recommended by the French guidelines. The French authorities aim to have 66 % of all procedures performed as same-day surgery in 2020. The aim of this study was to evaluate the feasibility and identify factors associated with success or failure of same-day surgery for minimally-invasive hysterectomy.
Study Design: We conducted a prospective double-center observational study at the Caen and Amiens University Hospitals between September 2017 and May 2018 including hospitalized patients managed for a laparoscopic or vaginal hysterectomy. Patients were younger than 70 and have no major medical problems. The patients were placed into a "fit" or "unfit" group according to their Post Anaesthetic Discharge Scoring System (PADSS) score 6 h post-surgery. All the patients were asked to complete an assessment questionnaire during their hospitalization.
Results: Of the 50 included patients, half were placed in the "fit" group. A history of laparotomy was significantly predictive of failure of same-day discharge (p = 0.003) but not uterine size or Body Mass Index (BMI). The main barriers for discharge were pain (p<0.001) and postoperative nausea/vomiting (PONV) (p<0.001). Four patients, all in the "unfit" group, had Clavien-Dindo grade 1 postoperative complications.
Conclusion: Same-day minimally invasive hysterectomy is a feasible and safe procedure. Factors associated with same-day hysterectomy failure were laparotomy, pain and postoperative nausea/vomiting.
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| http://dx.doi.org/10.1016/j.ejogrb.2020.07.019 | DOI Listing |
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Article Synopsis
- The study compares total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LSCH) during minimally invasive sacrocolpopexy for treating uterovaginal prolapse.
- Results showed no significant difference in overall recurrence of prolapse between the two methods, but TLH had lower odds of recurrence in multivariable analysis.
- TLH had a higher proportion of mesh exposures with lightweight mesh, but this finding wasn't significant after adjusting for other factors.
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