scholarly journals Peri-operative complications of Total laparoscopic hysterectomy for benign gynecological diseases in Fukuoka university

2021 ◽  
Vol 37 (1) ◽  
pp. 7-13
Author(s):  
Daisuke Miyahara ◽  
Fusanori Yotsumoto ◽  
Kenichi Yoshikawa ◽  
Tomohiro Ito ◽  
Sung Ouk Nam ◽  
...  
Keyword(s):  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Gynecological Diseases ◽  
Operative Complications ◽  
Benign Gynecological Diseases

scholarly journals A comparative study of non-descent vaginal hysterectomy and total laparoscopic hysterectomy

2020 ◽  
Vol 9 (2) ◽  
pp. 777
Author(s):  
Vijay Kansara ◽  
Jaydeep Chaudhari ◽  
Ajesh Desai
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Pap Smear ◽  
Operative Time ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Significant Difference ◽  
Operative Complications ◽  
Post Operative Complications

Background: Hysterectomy is the second most common operation performed by the gynecologists, next only to caesarean section. Objective of the study was to compare fall in blood haemoglobin level, duration of operation, intra- and post-op complications between non-descent vaginal hysterectomy and total laparoscopic hysterectomy and establish the better method for hysterectomy in non-descent uterus.Methods: A retrospective comparative study of 90 hysterectomies was done from a period of May 2018 - April 2019 at GMERS Medical College and Hospital Sola, with 45 cases in group of non-descent vaginal hysterectomy (NDVH) and 45 in group of total laparoscopic hysterectomy (TLH). Demographic characteristics, co-morbid conditions, indications for surgery, operative time, intra- operative blood loss, post-operative analgesia requirements, post-operative hospital stay and post-operative complications were compared between both groups. Those patients having malignancy as diagnosed by Pap smear or by D and C were excluded from the studyResults: The most common age in both groups was 41-50 years. Adenomyotic uterus was the most common indication for surgery in both groups. The mean operative time in NDVH group was 45 min while it was 80 min in TLH group. p<0.001 suggested significant difference when operative time were compared between both groups. Both groups were similar in post-operative analgesia requirement and post-operative hospital stay. Post-operative complications were similar in both groups.Conclusions: In which way to approach the uterus shall depend upon skill of the surgeon, size and pathological nature of uterus, technology available in the hospital and preference of patient as well as surgeon.

Seven-year survival analysis in women with unsuspected uterine malignancy after laparotomic versus laparoscopic hysterectomy: A national claim data retrospective cohort study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18096-e18096
Author(s):  
Jung Hun Lee ◽  
Jin-Sung Yuk
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Survival Analysis ◽  
Cox Regression ◽  
Laparoscopic Group ◽  
Laparoscopic Hysterectomy ◽  
Cox Regression Analysis ◽  
Incidence And Mortality ◽  
Gynecological Diseases ◽  
Benign Gynecological Diseases

e18096 Background: The primary aim of this study was to compare the overall survival of women with unsuspected uterine malignancy (UUM) diagnosed after laparotomic versus laparoscopic hysterectomy for benign gynecological diseases. Methods: A national health insurance database was analyzed from January 2006 to December 2010 to estimate the incidence and mortality of UUM diagnosed after hysterectomy for benign gynecologic diseases using diagnostic and procedure codes. Results: From the database (24 million women annually), 157,232 women were extracted. These women were divided into a laparotomic group (n = 103,631) and a laparoscopic group (n = 53,601). The overall incidences of UUM, unsuspected endometrial cancer, and UUM other than endometrial cancer were 0.65%, 0.46%, and 0.19%, respectively. Women with UUM diagnosed after hysterectomy showed no difference in mean age, incidence of UUM, or socioeconomic status in either group. Kaplan-Meier survival analysis and Cox regression analysis showed that the laparoscopic group was associated with more favorable overall survival than the laparotomic group, especially in UUM other than endometrial cancer ( p < 0.001). Conclusions: In women with UUM diagnosed after hysterectomy for presumed benign gynecological diseases, overall survival up to 7 years favors laparoscopic hysterectomy over laparotomic hysterectomy, and the incidence of UUM is relatively low. However, considering the devastating effect of intraperitoneal dissemination of UUM, surgeons should fully explain this issue to patients preoperatively and try to avoid intraperitoneal spread of tumor cells intraoperatively. [Table: see text]

scholarly journals Analysis of 300 Total Laparoscopic Hysterectomy Cases Performed by The Same Surgeon

2021 ◽  
Vol 3 (2) ◽  
pp. 20-24
Author(s):  
Esra Tamburacı ◽  
Barış Mulayim
Keyword(s):  
Hospital Stay ◽  
Open Surgery ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Technical Difficulty ◽  
Demographic Characteristics ◽  
Total Laparoscopic Hysterectomy ◽  
Conversion To Open Surgery ◽  
Operative Complications

Aim: This study aimed to evaluate the results of 300 cases of total laparoscopic hysterectomy (TLH) performed by the same surgeon. Material and methods: During the study period, a total of 300 TLH operations were performed between January 2017 and December 2018. Demographic characteristics, indications of hysterectomy, uterine weights, intra-operative and post-operative complications, duration of the operation, length of hospital stay, blood loss of patients, visual analogue scores and amount of analgesics needed were retrospectively evaluated. Complications were analysed and compared with literature. Results: Parameters analysed for 300 patients included in the study were as follows: mean age 47.82 ± 6.18 years, mean parity 3.4 ± 2.0 (0–11), BMI 27.41 ± 4.36 (kg/m²), mean uterine weight 367.67 ± 266.21 g (50–1600 g), mean operative time 89.07 ± 37.94 min (30–240 min), mean hospital stay 54.37 ± 21.95 h (24–168 h) and total complication rate 28 (9.3%). Conversion to open surgery was required in 29 (9.7%) patients. The level of technical difficulty and existence of prior abdominal surgery were associated with a higher risk of complications and conversions to laparotomy. Conclusion: Total laparoscopic hysterectomy is a well-designed surgical procedure for the management of benign gynaecological conditions, and after adequate training, it seems to be a safe and effective procedure for patients.

Risk factors of vaginal cuff infection in women undergoing laparoscopic hysterectomy for benign gynecological diseases

2021 ◽  
Vol 47 (4) ◽  
pp. 1502-1509
Author(s):  
Yoko Tsuzuki ◽  
Takumi Hirata ◽  
Shinya Tsuzuki ◽  
Shinichiro Wada ◽  
Akiko Tamakoshi
Keyword(s):  
Risk Factors ◽  
Laparoscopic Hysterectomy ◽  
Vaginal Cuff ◽  
Gynecological Diseases ◽  
Benign Gynecological Diseases

scholarly journals Hysterectomy for benign conditions: Complications relative to surgical approach and other variables that lead to post-operative readmission within 90 days of surgery

2017 ◽  
Vol 13 (2) ◽  
pp. 17-26 ◽  
Author(s):  
Neal M Lonky ◽  
Yasmina Mohan ◽  
Vicki Y Chiu ◽  
Jeanna Park ◽  
Seth Kivnick ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Vaginal Cuff ◽  
Laparoscopic Supracervical Hysterectomy ◽  
Supracervical Hysterectomy ◽  
Increased Risk ◽  
Operative Complications ◽  
Post Operative Complications

Objective: To examine variables associated with hysterectomy-related complications, relative to surgical approach and other variables, that lead to readmission within 90 days of surgery. Methods: We conducted an observational cohort study for which data were extracted from electronic health records. Data were extracted of all patients (n = 3106) who underwent hysterectomies at 10 Kaiser Permanente Southern California medical centers between June 2010 and September 2011. Patients who were pregnant or had a cancer diagnosis were excluded from the study. To identify univariate associations between examined variables and procedure type, chi-square tests for categorical variables and t-tests or analysis of variance for continuous variables were used. Generalized estimating equations methods were used to test associations between independent variables and primary outcomes of interest. Statistical significance was determined using a p-value <.05. Results: Of 3106 patients, 109 experienced 168 post-operative complications. The most common post-operative complications were related to pelvic abscesses, bowel obstruction, or severe ileus, and the vaginal cuff. Pelvic abscesses were most frequent among total laparoscopic hysterectomy and total abdominal hysterectomy cases (p = .002), and vaginal cuff complications were most frequent among total laparoscopic hysterectomy cases (p = .015). Patients who underwent total vaginal hysterectomy (odds ratio = 2.13, confidence interval = 1.15–3.92), laparoscopic supracervical hysterectomy (odds ratio = 3.11, confidence interval = 1.13–8.57), and total laparoscopic hysterectomy (odds ratio = 5.60, confidence interval = 2.90–10.79) experienced increased occurrence of post-operative complications resulting in readmission. Other variables associated with an increased risk for readmission included high estimated blood loss (201–300 mL and 301+ mL, relative to 0–50 mL; odds ratio = 2.28, confidence interval = 1.24–4.18 and odds ratio = 2.63, confidence interval = 1.67–4.14) and long length of stay of 3 days or more (relative to 0 days; odds ratio = 2.93, confidence interval = 1.28–6.69). Pelvic specimen weight in the 151–300 g and 501+ g ranges appeared protective (odds ratio = 0.40, confidence interval = 0.25–0.64 and odds ratio = 0.54, confidence interval = 0.33–0.90). In a sub-analysis of 1294 patients, 74 hospital operative complications directly related to hysterectomy were identified among 59 patients. The most common hospital operative complications were excessive bleeding associated with surgery or injury to nearby structures. Among the sub-sample of 1294 patients, those with hospital operative complications were more likely to experience post-operative complications that lead to readmission (odds ratio = 3.82, confidence interval = 1.55–9.43, p = .004). Conclusion: The observed increased risk of complications among patients of Black race, who underwent laparoscopic supracervical hysterectomy or total laparoscopic hysterectomy, who experienced more than 300 mL surgical blood loss, who suffered hospital operative complications, and those whose hospitalization was 3 days or greater, offers an opportunity for higher scrutiny and preventive measures during usual hysterectomy care to prevent later readmission.

Drivers of Cost for Total Laparoscopic Hysterectomy Performed by Gynecologic Oncologists

2011 ◽  
Vol 18 (6) ◽  
pp. S3
Author(s):  
K.M. Esselen ◽  
D. Boruta ◽  
J. Schorge ◽  
A. Goodman ◽  
M. del Carmen ◽  
...  
Keyword(s):  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy
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