scholarly journals Total Laparoscopic Hysterectomy in Patients with Large Uteri: Comparison of Uterine Removal by Transvaginal and Uterine Morcellation Approaches

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Haibo Wang ◽  
Ping Li ◽  
Xiujuan Li ◽  
Licai Gao ◽  
Caihong Lu ◽  
...  
Keyword(s):  
Intraoperative Complications ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Postoperative Outcomes ◽  
Statistical Significant Difference ◽  
Removal Time ◽  
Significant Difference ◽  
Large Uterus

The aim of this study was to compare the clinical results of total laparoscopic hysterectomy (TLH) for large uterus with uterus size of 12 gestational weeks (g.w.) or greater through transvaginal or uterine morcellation approaches. We retrospectively collected the clinical data of those undergoing total laparoscopic hysterectomies between January 2004 and June 2012. Intraoperative and postoperative outcomes were compared between patients whose large uterus was removed through transvaginal or morcellation approaches. The morcellation group has significantly shorter mean operation time and uterus removal time and smaller incidence of intraoperative complications than the transvaginal group (allP<0.05). No statistical significant difference regarding the mean blood loss, uterine weight, and length of hospital stay was noted in the morcellation and transvaginal groups (allP>0.05). In two groups, there was one patient in each group who underwent conversion to laparotomy due to huge uterus size. With regard to postoperative complications, there was no statistical significant difference regarding the frequencies of pelvic hematoma, vaginal stump infection, and lower limb venous thrombosis in two groups (allP>0.05). TLH through uterine morcellation can reduce the operation time, uterus removal time, and the intraoperative complications and provide comparable postoperative outcomes compared to that through the transvaginal approaches.

scholarly journals Total laparoscopic hysterectomy in the grossly enlarged uterus

2005 ◽  
Vol 54 (5S) ◽  
pp. 20a-21a
Author(s):  
R. Botchorishvili ◽  
B. Rabischong ◽  
К. Jardon ◽  
J. L. Pouly ◽  
G. Mage ◽  
...  
Keyword(s):  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Size Limitation ◽  
Recovery Times ◽  
Large Uterus ◽  
Laparoscopic Assisted

Introduction: Avoiding laparotomy by performing laparoscopic hysterectomy, of various types, has been shown to be beneficial in a number of ways. Shorter recovery times, shorter length of hospital stay and convalescence period, and earlier return to work than after abdominal hysterectomy are some of the positive factors cited. However, it is often considered that there is a size limitation of 14-16 weeks gestation to the feasibility of laparoscopic hysterectomy. Whilst a number of studies have shown that the laparoscopic-assisted vaginal hysterectomy (LAVH) successfully manages the large uterus, little has been published regarding a total laparoscopic approach.

scholarly journals Total laparoscopic hysterectomy for large uterus

2009 ◽  
Vol 1 (1) ◽  
pp. 34 ◽  
Author(s):  
Meenakshi Sundaram ◽  
Smita Lakhotia ◽  
Chaitali Mahajan ◽  
Gayatri Manaktala ◽  
Parul Shah ◽  
...  
Keyword(s):  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Large Uterus

scholarly journals Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

2020 ◽  
pp. 145749692093860
Author(s):  
T. Mönttinen ◽  
H. Kangaspunta ◽  
J. Laukkarinen ◽  
M. Ukkonen
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Time Of Day ◽  
University Hospital ◽  
Patient Comfort ◽  
Intraoperative Bleeding ◽  
Significant Difference ◽  
Clinically Significant

Introduction: Although it is controversial whether appendectomy can be safely delayed, it is often unnecessary to postpone operation as a shorter delay may increase patient comfort, enables quicker recovery, and decreases costs. In this study, we sought to study whether the time of day influences the outcomes among patients operated on for acute appendicitis. Materials and Methods: Consecutive patients undergoing appendectomy at Tampere University Hospital between 1 September 2014 and 30 April 2017 for acute appendicitis were included. Primary outcome measures were postoperative morbidity, mortality, length of hospital stay, and amount of intraoperative bleeding. Appendectomies were divided into daytime and nighttime operations. Results: A total of 1198 patients underwent appendectomy, of which 65% were operated during daytime and 35% during nighttime. Patient and disease-related characteristics were similar in both groups. The overall morbidity and mortality rates were 4.8% and 0.2%, respectively. No time categories were associated with risk of complications or complication severity. Neither was there difference in operation time and clinically significant difference in intraoperative bleeding. Patients undergoing surgery during night hours had a shorter hospital stay. In multivariate analysis, only complicated appendicitis was associated with worse outcomes. Discussion: We have shown that nighttime appendectomy is associated with similar outcomes than daytime appendectomy. Subsequently, appendectomy should be planned for the next available slot, minimizing delay whenever possible.

scholarly journals Single-port access versus conventional multi-port access total laparoscopic hysterectomy for very large uterus

2015 ◽  
Vol 58 (3) ◽  
pp. 239 ◽  
Author(s):  
Jinhwa Lee ◽  
Sunghoon Kim ◽  
Eun Ji Nam ◽  
Sun Mi Hwang ◽  
Young Tae Kim ◽  
...  
Keyword(s):  
Single Port ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Single Port Access ◽  
Port Access ◽  
Large Uterus

scholarly journals Total Laparoscopic Hysterectomy Outcomes for Large Uterus (>14Weeks) Due to Large and Multiple Fibroids

2019 ◽  
Vol 29 (3) ◽  
pp. 110-115
Author(s):  
Betül YAKIŞTIRAN ◽  
Yavuz Emre ŞÜKÜR ◽  
Bülent BERKER ◽  
Salih TAŞKIN ◽  
Batuhan ÖZMEN ◽  
...  
Keyword(s):  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Large Uterus

scholarly journals Transforaminal and Posterior Lumbar Interbody Fusion for Llumbar Degenerative Diseases, which one is better: A meta-analysis Through a Ggrade Analysis of Evidence

2021 ◽  
Author(s):  
aixian tian ◽  
xinlong ma ◽  
jianxiong Ma
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Meta Analysis ◽  
Posterior Lumbar Interbody Fusion ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Significant Difference

Abstract BackgroundTo explore the efficacy and safety between posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar degenerative diseases.MethodsWe searched the literature in Pubmed, Embase, Cochrane Library and Web of Science. The index words were posterior lumbar interbody fusion, PLIF, transforaminal lumbar interbody fusion, TLIF, lumbar interbody fusion, spinal fusion, degenerative disc disease and lumbar degenerative diseases. Primary outcomes were fusion rate and complications. Secondary outcomes were visual analog scale (ΔVAS), Oswestry Disability Index (ΔODI), total blood loss, operation time and length of hospital stay. Review Manager 5.3 and Stata13.1 was used for the analysis of forest plots, heterogeneity, sensitivity and publication bias.Results17 studies were included (N=1562; PLIF, n=835; TLIF, n=727). The pooled data showed PLIF had a higher complications (P= 0.000), especially in nerve injury (p = 0.003) and dural tear (p = 0.005). PLIF required longer operation time (p = 0.004), more blood loss (p = 0.000) and hospital stays (p = 0.006). Surprisingly subgroup analysis showed there was significant difference in complications in patients under 55 (p = 0.000) and Asian countries (p = 0.000). No statistical difference was found between the two groups with regard to fusion rate (p = 0.593),ΔVAS (p = 0.364) andΔODI (p = 0.237).ConclusionsThis meta-analysis showed there were no significant difference in fusion rate, ΔVAS and ΔODI. However TLIF could reduce complications, especially nerve injury and dural tear. Besides, TLIF was associated with statistically significant less blood loss, shorter operation time and shorter length of hospital stay.

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