scholarly journals Comparison of laparoscopic-assisted vaginal hysterectomy, total abdominal hysterectomy and vaginal hysterectomy: A four years retrospective study in tertiary care centre

2018 ◽  
Vol 7 (9) ◽  
pp. 3596
Author(s):  
Namrata Vasant Padvi ◽  
Jitendra Pundalik Ghumare
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Tertiary Care ◽  
Operating Time ◽  
Abdominal Hysterectomy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Average Hospital ◽  
Intraoperative Complication ◽  
Estimated Blood Loss

Background: Hysterectomy is one of the commonest gynaecological operations performed in India. Traditional surgical treatments performed are abdominal hysterectomy and vaginal hysterectomy. Vaginal and laparoscopic procedures are considered “minimally invasive” surgical approaches because they do not require a large abdominal incision and, thus, typically are associated with shortened hospitalization and postoperative recovery times compared with open abdominal hysterectomy. With the aid of laparoscopic procedure, a potential abdominal hysterectomy can be converted to a vaginal one and a difficult vaginal hysterectomy can be converted into a fairly simple vaginal hysterectomy. Aim of the present study is to compare above methods of hysterectomy in terms of operating time, estimated blood loss, and postoperative hospital stay and complication, so as to provide best course of treatment to patient.Methods: A retrospective observational study was conducted in tertiary care centre. Four-year data was collected from January 2012 to December 2016. Cases of LAVH with benign gynaecological condition and up to 12 weeks size uterus, without any associated medical condition were selected in study randomly, and compare with cases of NDVH, TAH in terms of duration of operative procedure, blood loss during surgery, and postoperative hospital stay.Results: In present study we found that average duration of procedure in LAVH was 84.35 minute, which was maximum compare to other method. Estimated blood loss in LAVH was least as compare to NDVH and TAH it was maximum. The average hospital stays in LAVH and NDVH was less as compared to TAH.Conclusions: LAVH should be considered a better approach in view of the relatively less blood loss and intraoperative complication. Due to lack of large randomized controlled trials, the role of Laparoscopic hysterectomy is difficult to define.

scholarly journals Retrospective analysis of elective hysterectomy cases in a tertiary care centre

2018 ◽  
Vol 7 (9) ◽  
pp. 3714
Author(s):  
Divya R. Prasad ◽  
Neelima V. Nair
Keyword(s):  
Retrospective Analysis ◽  
Vaginal Hysterectomy ◽  
Tertiary Care ◽  
Abdominal Hysterectomy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Fibroid Uterus ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted

Background: Often hysterectomy remains the only option available in many gynaecological conditions, though it is resented by most women. This study aims to analyse the cases of hysterectomy performed in a tertiary care centre in India, with a view to modify and improve health care provided to women.Methods: A retrospective analysis of 500 cases of elective hysterectomy in Sree Gokulam Medical College and Research Foundation from January 2016 to December 2017 was done from hospital records. The observations according to age, indications of hysterectomy, route of hysterectomy and preservation of ovaries were statistically analysed.Results: 35.2% (176 cases) were between 45 and 50 years. Mean age was 48±2 years. 90.4% (452 cases) were done in women above 40 years of age. The commonest indication for hysterectomy was symptomatic fibroid uterus 59.4% (297 cases). 81.8% (409 cases) women underwent abdominal hysterectomy while 18.2 % (91 cases) women underwent vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy. 84.6% (77 of 91 cases) of vaginal hysterectomy was done for prolapse uterus. Preservation of one or both ovaries was done in 47.2% (236 cases).Conclusions: Hysterectomy is usually done after the age of 40 years with the mean age being 48±2 years. Symptomatic fibroid uterus was the most common indication. The rates of vaginal hysterectomy were lower for indications other than prolapse uterus. Ovaries were preserved in several cases.

scholarly journals Comparison between Laparoscopic, Abdominal, and Vaginal Hysterectomy in the Treatment of Gynecological Disease: A Retrospective Review Over Five Years

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Laparoscopic Group ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Bladder Injury ◽  
Estimated Blood Loss ◽  
Operative Complications ◽  
Gynecological Disease

Background: Hysterectomy is one of the most common gynecological surgery worldwide. It is usually performed through the abdominal, vaginal or laparoscopic routes. The objective of this study was to evaluate the role of laparoscopic, vaginal and abdominal hysterectomy in the management of gynecological conditions in terms of operative outcomes, such as operating time and estimated blood loss, as well as complication rates. Methods: This was a retrospective cohort study carried out over a 5-year period (2016-2020) at Zahraa University Hospital. Patients who underwent abdominal vaginal, and laparoscopic hysterectomies performed for the treatment of multiple gynecological disease during that period were included. Results: A total of 222 patients were included in the study, 168 (75.7%) patients in the abdominal hysterectomy group, 7 (3.2%) in the vaginal group, and 47 (21.1%) in the laparoscopic group. The mean age was 49.83±9.28 years for the abdominal, 67.14±13.79 for the vaginal, and 47.26±6.77 years for the hysterectomy groups. The most common indication for hysterectomy was the presence of uterine fibroids in the abdominal and laparoscopic groups (47.6% vs. 31.9% respectively) whereas it was pelvic organ prolapse for all patients in the vaginal group. Around 18% in the abdominal group had abnormal uterine bleeding compared to 6.4% in the laparoscopic group. Endometrial hyperplasia was the indication for 9.5% of the patients in the abdominal group while it was 25.5% for the laparoscopic group. Surgery duration was significantly the shortest for abdominal hysterectomy (2.30±0.92 hours), followed by vaginal hysterectomy (2.86±0.24 hours), and the longest was for laparoscopic hysterectomy (4.14±0.90 hours) (p-value<0.0001). The size of the uterus was slightly larger in the abdominal hysterectomy group though the difference was not significantly different. There were no significant differences in pre- and post-operative hemoglobin, or in estimated blood loss among the groups. There were no complications in the vaginal group. The rate of complications was similar between the abdominal and laparoscopic groups (15.5% vs. 17.0% respectively). The most common type of intraoperative complication in the abdominal group was bleeding requiring transfusion (34.6%), followed by bladder injury (11.5%). Only one patient in the laparoscopic group had intra-operative complication (bladder injury). As for post-operative complications, urinary retention and pyrexia related to wound infection were the most common in the abdominal group (7.7%). Seven patients in the laparoscopic group had post-operative complications. Most patients were readmitted to the hospital (98.8% vs. 100.0% vs. 95.7% in the abdominal vs. vaginal vs. laparoscopic groups respectively). Conclusion: Laparoscopic hysterectomy is associated with less morbidity, and shorter hospital stay than the other techniques, but it has longer operating time and requires laparoscopic instrument and surgical skills. Advances in equipment, surgical techniques, and training make laparoscopic hysterectomy an efficient and well-tolerated technique.

scholarly journals A Comparative evaluation of Non-descent vaginal hysterectomy versus total Abdominal hysterectomy: A hospital based case control study

2019 ◽  
Vol 17 (1) ◽  
pp. 20-22
Author(s):  
Durga BC ◽  
Aseem Sharma ◽  
Binod Mahaseth ◽  
Nirmala Sharma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Benign Pathology ◽  
Operative Complications ◽  
Control Study ◽  
Post Operative Complications

Background: Hysterectomy is a common surgery performed by gynecologist worldwide. It can be done either by vaginal, abdominal or laparoscopic route. Non decent vaginal hysterectomy (NDVH) is less invasive, less time consuming and scar less surgery. The blood loss during surgery, intra-operative and post-operative complications are less in NDVH compare to TAH (total abdominal hysterectomy). Aim and objective: to compare the clinical outcome between NDVH and TAH. Method: A hospital based prospective study was done at Nepalgunj medical collage Kolhapur between March 2018–March 2019, 60 cases fulfilling selection criteria were selected, 30 cases underwent NDVH next 30 cases underwent TAH. Outcome is measured on the basis of operating time, blood loss during surgery, hospital stay and post-operative complications. Result: The most common indication for hysterectomy was fibroid uterus in both the groups (NDVH and TAH). The operating time, blood loss, hospital stay and post-operative complications were less in NDVH as compare to TAH. Conclusion: NDVH is a choice of surgery over TAH for freely mobile uterus with benign pathology and uterus size less than twelve weeks and without adenexal pathology.

scholarly journals Evaluation of hysterectomy in a tertiary care hospital of central India: a retroprospective study

2021 ◽  
Author(s):  
Anchala Mahilange
Keyword(s):  
Tertiary Care ◽  
Operating Time ◽  
Central India ◽  
Laparoscopic Hysterectomy ◽  
Developed Countries ◽  
Abdominal Hysterectomy ◽  
Care Hospital ◽  
Age Group ◽  
Vaginal Route ◽  
Average Hospital

Background: Hysterectomy is the most common gynaecological surgical procedure after caesarean section. In India there is lower rate (4-6%) of hysterectomy has been reported, while there is higher frequency of hysterectomy (10-20%) in developed countries. Currently there are three main types of hysterectomy operations in practice for benign diseases abdominal hysterectomy, vaginal hysterectomy and laparoscopic hysterectomy. Abdominal hysterectomy remains the predominant method of uterus removal. The present study was planned t to analyse changes in the trends of hysterectomy from past 3 year in the study area.Methods: The present observational study was conducted in department of obstetrics and gynaecology and associated Dr. B.R.A.M. hospital Raipur (CG), India. Data was collected retrospectively from January 2009 to May 2012 from hospital medical records. Prospectively data was obtained from patient and his file from June 2013 to September 2014. Data was compiled in MS-excel and checked for its completeness and correctness, and then it was analyzed by using suitable software.Results: Total no of hysterectomy conducted in study duration was 1000. Study showed declining trend of hysterectomy in our institute. Most common age group of hysterectomy was 41-50 year. which 45.8% followed by age group 31-40 that is 32.5%. Most common indication of hysterectomy was fibroid uterus 33.6% followed by prolapse uterus 29.5%. 29% cases were operated via vaginal route for descent of uterus and 21% cases operated by vaginal route for non-descent uterus.50% cases were operated via abdominal route. Average operating time for TAH was 1.43±0.50, for VH was 1.08±0.03. Average hospital stay for TAH was 8.87±3.31 and VH was 5.27±1.07. Conclusions: In our study it had been seen that rate of hysterectomy is in decreasing trend as more conservative approach is now preferred. To minimize most of complications of hysterectomy second opinion fresh eyes and multi-disciplinary approach is recommend in all patients undergoing this procedure.

Coblation tonsillectomy: our experience as a day care procedure

2021 ◽  
Vol 7 (5) ◽  
pp. 764
Author(s):  
Kripamoy Nath ◽  
Ritu Gupta
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Day Care ◽  
Tertiary Care ◽  
Operating Time ◽  
Tertiary Care Centre ◽  
Post Operative Pain ◽  
Care Surgery ◽  
A Prospective Study ◽  
Care Procedure

<p class="abstract"><strong>Background: </strong>A prospective study to cite our experience in adult and pediatric patients undergoing coblation tonsillectomy. We emphasised on the intra operative and post operative morbidity in coblation tonsillectomy and its feasibility as a day care procedure.</p><p class="abstract"><strong>Methods: </strong>It is a prospective study done on both paediatric and adult cases presenting to our tertiary care centre between January 2018 to February 2020. Study was done to analyse operating time, intraoperative blood loss, post-operative pain, post-operative haemorrhage and post-operative return to home and normal diet.</p><p class="abstract"><strong>Results: </strong>114 cases were selected where bilateral tonsillectomy was performed using Coblation technique. 83 were adult patients and 31 paediatric. 56 were females and 58 males. 1 case presented with secondary haemorrhage, none with primary haemorrhage. No other complications were noted.</p><p class="abstract"><strong>Conclusions: </strong>Coblation tonsillectomy yielded good results in reference to patient morbidity and low complication rate. It turned out to be a success as a day care procedure. Short operating time, minimal blood loss, less post-operative pain specially in the early post-operative period, minimal chance of complication and short stay at hospital as a day care surgery, Coblation tonsillectomy stood out as a hands down winner in our study. In this fast paced life, where consumerism demands everything instant, coblation tonsillectomy as a day care procedure provides good alternative to the patient requiring tonsillectomy. yroidectomies.</p>

scholarly journals Laparoscopic nephrectomy: Moroccan experience of 68 cases

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Abdoulazizi Bilgo ◽  
Amine Saouli ◽  
Tarik Karmouni ◽  
Khalid El Khader ◽  
Abdellatif Koutani ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Intraoperative Complications ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Upper Urinary Tract ◽  
Laparoscopic Nephrectomy ◽  
Reliable Technique ◽  
Average Hospital ◽  
Estimated Blood Loss

Abstract Background The aim of this study was to analyze the feasibility and the safety of laparoscopic nephrectomy in the treatment of pathologies of the upper urinary tract through the experience of the Urology B department. Methods We have retrospectively and monocentrally selected patients who underwent laparoscopic nephrectomy from January 2017 to December 2019. The collection was carried out on archived files, based on demographic, clinical and perioperative data. The primary endpoint was the occurrence of complications and secondarily the length of the operation and the length of hospital stay. The statistical analysis was carried out using the SPSS software. Results A total of 68 patients were included in our series. The average age of our patients was 57.8 years. There was a slight female predominance: 39 female patients (57.4%) for 29 male patients (42.6%). Indications for nephrectomy were dominated by renal tumor (33.82%) followed by lithiasis (16.17%) and non-functioning kidney (16.17%) at the same rank. During the study period, 31 (45.6%) simple nephrectomy, 26 (38.2%) total nephrectomy, 1 (1.5%) partial nephrectomy and 10 (14.7%) nephroureterectomy were performed in our department. In our series, the average operating time was 180 min. Estimated blood loss averaged 321.8 ml with extremes of a few milliliter to 1100 ml. Intraoperative complications were reported in 10 (14.7%) patients; conversion was necessary in 6 cases (8.82%). The postoperative follow-up was straightforward in 53 (77.94%) patients with an average hospital stay of 3.6 days. The rate of postoperative complications according to Clavien–Dindo was 22.1%. Histological examination of the nephrectomies carried out in our department revealed mainly chronic non-specific pyelonephritis in 24 (35.3%) patients, followed by renal cell carcinoma in 23 (33.82%) patients and urothelial carcinoma in 9 (13.2%) patients. Conclusion Laparoscopic nephrectomy appears to be an efficient and reliable technique. This technique has led to a significant improvement in operative morbidity, mainly represented by the length of hospital stay, operating time and blood loss.

scholarly journals Comparative study of nondescent vaginal hysterectomy and abdominal hysterectomy at tertiary care centre, Maharashtra

2021 ◽  
Vol 10 (9) ◽  
pp. 3397
Author(s):  
Sharayu Prashant Mujumdar ◽  
Priyanka Kunal Purohit ◽  
Shwetambari S. Navale ◽  
Chintan M. Upadhyay
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Study Groups ◽  
Abdominal Hysterectomy ◽  
Economic Benefits ◽  
Tertiary Care Centre ◽  
Abdominal Incision ◽  
Operative Complication ◽  
Duration Of Surgery

Background: Vaginal route of hysterectomy has distinct health and economic benefits in terms of less morbidity, better postoperative quality of life outcomes, reduced hospital stay and better patient satisfaction. Objectives of current study were to evaluate the appropriate route of hysterectomy (abdominal or vaginal) in terms of intra and post-operative complication, morbidity and blood loss. Methods: This prospective study was done among 100 cases of hysterectomy of which 50 patients underwent NDVH and 50 underwent abdominal hysterectomy. This study included all emergency and booked patients having Size of uterus less than 12 weeks size, adequate uterine mobility, adequate access, adenomyosis, dysfunctional uterine bleeding, chronic PID & fibroid uterus.Results: Study found statistically significantly higher number of the participants with parity 3 & 4 in both the study groups. Bulky uterus followed by 12 and 10 weeks uterus in statistically significantly higher number of the participants of both the study groups. Duration of surgery statistically significantly less in NDVH group compare to TAH group. Fibroid was the main indication of hysterectomy in both the groups. Hemorrhage was the main intra-operative complication in both the groups. Fever & respiratory tract infection was the main post-operative complications in both the groups.Conclusions: Benefits of NDVH over TAH are Cosmetic advantage as less invasive, No discomfort of abdominal incision, shorter operative time, lesser blood loss, lesser intraoperative and postoperative complications, postoperative comfort is more, lesser requirement of postoperative analgesia, early ambulation and shorter hospital stay.

scholarly journals Comparative Study of Non-descent Vaginal Hysterectomy with Total Abdominal Hysterectomy

2021 ◽  
Vol 17 (3) ◽  
pp. 220-226
Author(s):  
Rubina Shrestha ◽  
Subha Shrestha ◽  
Satindar Ray
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Medical Science ◽  
Operating Time ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Operative Complications ◽  
Hospital Stays ◽  
Post Operative Complications

IntroductionHysterectomy is the most common operation performed by gynecologist worldwide. In the present era emphasis is given on minimal invasive surgery so Non-Descent Vaginal Hysterectomy (NDVH) has gained more interest over Total abdominal Hysterectomy (TAH). NDVH has several benefits over TAH in terms of blood loss, operating time, post-operative complications, recovery and hospital stays. The objective of the study was to compare the clinical outcome of NDVH over TAH with respect to operating time, blood loss, hospital stays, intraoperative and early postoperative complication and to find out the most efficient route for hysterectomy.  MethodsThe study was conducted at College of Medical Science-Teaching Hospital, Bharatpur, Chitwan, Nepal between May 2017- May 2020. Fifty cases each of NDVH and TAH group fulfilling the selection criteria were included in the study. Outcome was measured on the basis of operating time, blood loss, hospital stay and intra an d post-operative complications.  ResultsBaseline characteristics were similar between both the groups. The most common indicationfor hysterectomy in both the group was fibroid uterus. There was no intra-operativecomplication in NDVH group but in TAH group bowel injury was encountered in 3 cases.The operating time, blood loss, hospital stay and post-operative complications were less inNDVH as compare to TAH ConclusionsNDVH is the better choice of surgery than TAH for the non-prolapsed uterus, size less than12 weeks with benign pathology.

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