scholarly journals A comparative analysis of hysterectomies

Medicina ◽  
2007 ◽  
Vol 43 (2) ◽  
pp. 118 ◽  
Author(s):  
Rosita Aniulienė ◽  
Laima Varžgalienė ◽  
Manvydas Varžgalis
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Complication Rate ◽  
Vaginal Hysterectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Obstetrics And Gynecology ◽  
Significant Difference ◽  
The Mean

The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital. Methods. A retrospective review of medical histories was performed for women who had undergone three different types of hysterectomies (laparoscopic, vaginal, and abdominal) at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital during 2004–2005. Results. A total of 602 hysterectomies were performed: 51 (8.5%) laparoscopic, 203 (33.7%) vaginal, and 348 (57.8%) abdominal. The lowest complication rate occurred in patients who underwent laparoscopic hysterectomy (n=5, 9.8%) and the highest – abdominal hysterectomy (n=88, 25.2%) (P<0.05). More complication occurred after abdominal as compared to vaginal hysterectomy (n=88, 25.2% vs. n=20, 9.9%, respectively; P<0.05). There was no statistically significant difference in complication rate comparing laparoscopic and vaginal hysterectomies (P=0.26). The amount of blood loss depended on the type of hysterectomy – less blood was lost during laparoscopic and more during abdominal hysterectomy (123.4 vs. 308.5 mL, respectively; P<0.01). A significantly higher blood loss was observed during abdominal hysterectomy as compared to vaginal (195.3 mL) and vaginal as compared to laparoscopic hysterectomy (P<0.01). The mean length of hospital stay differed comparing all three types of hysterectomies: the shortest stay of 8.6 days was after laparoscopic, the longest of 13.7 days – after abdominal hysterectomy. The mean hospital stay was statistically significant shorter for vaginal hysterectomy compared to abdominal hysterectomy (9.1 vs. 13.7 days, P<0.01). The difference in mean length of hospital stay was insignificant comparing laparoscopic and vaginal hysterectomies (P>0.05). Conclusions. Abdominal hysterectomy was the most common procedure performed. The type of hysterectomy influenced the rate of complications – the lowest complication rate was after laparoscopic and vaginal hysterectomies. The amount of blood loss depended on the type of hysterectomy – the lowest was during laparoscopic hysterectomy. Abdominal hysterectomy required on average a longer hospital stay compared with laparoscopic and vaginal hysterectomies.

scholarly journals Laparoscopic Hysterectomy Versus Abdominal Hysterectomy of Enlarged Uterus

2020 ◽  
Vol 3 (1) ◽  
pp. 01-08
Author(s):  
Bassem Islam
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Estimated Blood Loss ◽  
Significant Difference

This prospective interventional to assess feasibility of total laparoscopic hysterectomy (LH) for uteri weighing 280 gm or more. The study included 120 patients divided to 60 patient conducted total laparoscopic hysterectomies and 60 patients conduct total abdominal hysterectomy as standard method. Full history taking, gynecologic examination and ultrasound examination were done to all patients. The following data were collected from every patient in all groups: Age, BMI, uterine weight, Operative time, Estimated intraoperative blood loss, Preoperative hemoglobin and postoperative hemoglobin deficit 12 hours after surgery, intraoperative and Post-operative complications, Time to resumption of bowel movements to normal, Length of hospital stay. The most common indication among our patients was fibroid uterus while adenomyosis came second. All operations were performed by the same surgeons and using the same technique. We observe BMI is not considering as obstacle in laparoscopic group with advancement of anesthesia and sealing system. The mean operating time was slightly but not significally lower in laparoscopic hysterectomy with highly significant difference in the estimated blood loss in favor of laparoscopic group. The total incidence of intra-operative and postoperative complication of patient submitted to laparoscopic hysterectomy lower than conventional hysterectomy group but not statically significantly. There was significant difference in pain scoring, earlier bowel movement and hospital stay in the arm of laparoscopic group.

scholarly journals Laparoscopic Assisted Vaginal Hysterectomy: A Case Control Comparative Study with Total Abdominal Hysterectomy

2014 ◽  
Vol 8 (2) ◽  
pp. 59-62
Author(s):  
Fahmida Zesmin ◽  
Begum Hosne Ara ◽  
Fatema Begum ◽  
Nusrat Fatima
Keyword(s):  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Length Of Hospital Stay ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Case Control ◽  
Eligibility Criteria ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Number Of Patients ◽  
Significant Difference

This case control study was conducted in the department of Gynae & Obstetrics, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), Dhaka, during the period of January 2008 to December 2008 to compare the length of operation, blood loss, length of hospital stay, drug requirements for pain and post-operative pain and activity levels between Laparoscopically Assisted Vaginal Hysterectomy (LAVH) & Total Abdominal Hysterectomy (TAH). A total of 50 patients who met some eligibility criteria were consecutively included in the study and matched in a case control manner for age, weight, diagnosis & uterine size. The procedures were performed by the same surgeon. On average, LAVH operations took significantly longer than TAH operations (P<0.001). Equal number of patients of both groups (40%) needed blood transfusion. No significant difference about haemoglobin level compared to TAH group on 3rd POD (P=0.246). However total amount of analgesics needed was much higher in the TAH group than that of the LAVH group (243.7 ± 40.3VS 182.1 ± 69.6 mg; P= 0.005) and the total cost of operation was significantly less in the TAH group (4500 ± 500 takas) than in the LAVH group (6500 ± 500 taka) (P<0.001). It was observed that LAVH group produced earlier relief from pain in terms of pain VAS on 3rd POD, (P<0.001). LAVH is less painful, has a shorter length of hospital stay and quicker return to work than TAH. Moreover LAVH does not increase intra or postoperative complications. DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20370 Faridpur Med. Coll. J. 2013;8(2): 59-62

scholarly journals Comparative study of surgical results between total abdominal hysterectomy and total laparoscopic hysterectomy in a tertiary hospital: a 2 year retrospective study

2018 ◽  
Vol 7 (3) ◽  
pp. 1019
Author(s):  
Kanmani M. ◽  
Mirudhubashini Govindarajan ◽  
Vishranthi Selvaraj
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Pelvic Surgery ◽  
Surgical Results ◽  
Significant Difference

Background: Since the introduction of Laparoscopic hysterectomy by Reich in 1989, it has become a widely accepted technique worldwide. The aim of the study was to compare the surgical results between Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH).Methods: We conducted a retrospective study at Women’s center and hospitals between June 2014 to May 2016, 32 patients who underwent TAH and 55 patients who underwent TLH, were included.Results: We observed that there was no significant difference between the two groups in respect to patient's demographic characteristics, indication of surgery, uterine size, or with history of previous pelvic surgery. Duration of surgery was found to be longer in TLH than TAH (124±39.7 min vs. 104.7±39.8 min). The length of hospital stay was less in TLH than TLH (P-0.0001) and the amount of blood loss were also less in TLH than TAH (103±149 ml versus 243±210 ml). There was no significant difference in view of intra and post operative complications. Hemoglobin change was statistically significant and is more with TAH than TLH (1.57±0.7g% versus 1.12±0.7g%).Conclusions: This study showed that TLH can be safely performed by the experienced surgeon in order to reduce the blood loss, duration of hospital stay and the quality of life.

scholarly journals A comparative study between total laparoscopic hysterectomy and total abdominal hysterectomy for benign uterine pathologies at tertiary care institute, Udaipur

2021 ◽  
Vol 10 (10) ◽  
pp. 3806
Author(s):  
Shatendra Kumar Goyal ◽  
Madhubala Chauhan ◽  
Babita Kanwat ◽  
Dinesh Mehra
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Study Patient ◽  
Early Ambulation

Background: Hysterectomy is one of the most commonly performed procedures in gynaecological surgery. The most common indication is benign uterine disease. As the time is passing trend is towards those approaches which are minimally invasive, less painful, have less complications, less blood loss and are more cosmetic. Thus, total laparoscopic hysterectomy has gained popularity. The purpose of this study was to compare the 2 different routes of hysterectomy.Methods: In this prospective randomized observational study patients undergoing both the types of hysterectomy, that is, TAH (total abdominal hysterectomy) and TLH (total laparoscopic hysterectomy) during 2 year period at Rajkiya Pannadhay Mahila Chikitsalaya RNT medical college Udaipur were included in the study. 50 women (25 in each group) aged between 31-72 years were included into the study.Results: We observed that duration of surgery was found to be longer in TLH than TAH (112.56±19.45 min versus 57.9±19.26 min, P<0.001 (HS)). The length of hospital stay was less in TLH than TLH (p=0.0001) and the amount of intra-operative blood loss were also less in TLH than TAH (163.60±44.15 versus 313.20±123.48 ml, p<0.001). TLH group had early ambulation compared to TAH group (2.24±0.44 day versus 3.12 ±0.33 day, p<0.001), difference on the basis of length of hospital stay was highly significant which was shorter in TLH than TAH (4.40±1.15 versus 10.32±8.19 days, respectively; p<0.001). In current study patient satisfaction level was found highly significant between TLH and TAH (100% versus 56%, p<0.001).Conclusions: TLH is a safe and effective method of doing hysterectomy. The present study concluded that TLH is associated with less hospital stay, less blood loss, less use of analgesics, early ambulation, early start of oral feed, and better patient satisfaction. 

scholarly journals Evaluation of clinical outcome of laparoscopic hysterectomy versus open abdominal hysterectomy with pelvic lymphadenectomy in endometrial carcinoma early stage

2021 ◽  
Vol 10 (6) ◽  
pp. 2203
Author(s):  
Waleed M. Tawfik ◽  
Wagdy M. Amer ◽  
Ahmed F. Sherif
Keyword(s):  
Endometrial Cancer ◽  
Blood Loss ◽  
Hospital Stay ◽  
Early Stage ◽  
Clinical Stage ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Lymphadenectomy ◽  
The Mean

Background: the aim of this study was to compare the operative, post-operative, and the oncological short-term outcomes of laparoscopic hysterectomy with lymphadenectomy and open abdominal hysterectomy with lymphadenectomy for early-stage endometrial cancer.Methods: 80 patients with clinical stage I endometrial cancer were enrolled in this trial; they were divided according to their selection of the method of intervention after counselling into two groups: total laparoscopic hysterectomy with pelvic lymphadenectomy group and total abdominal hysterectomy with pelvic lymphadenectomy group.Results: The mean operative time in the TLH group was 140.85± 10.033 minutes and was 118.45±12.713 minutes in the TAH group (p<0.001). The mean blood loss in the TLH group was 127.5±42.9 ml and 220.5± 84.82 ml in TAH group (p<0.001). The mean duration of postoperative ileus was 12.8±5.022 hours in the TLH group, and it was 22.3±5.573 hours in the TAH group (p<0.001). The mean time of hospital stay in the TLH group was 26.7±5.667 hours and in the TAH group was 116.4± 17.31 hours (p<0.001).Conclusions: Complete surgical staging of endometrial cancer can be performed using laparoscopy as an alternative to routine open method with similar efficacy about nodal retrieval and complication rate, and better operative and postoperative compliance in means of blood loss, ileus and hospital stay which may have an implication on cost saving in the medical service. Lymphadenectomy can be omitted in low-risk cases of endometrial cancer.

scholarly journals TLH versus TAH: a 2 year retrospective comparative study

2019 ◽  
Vol 8 (10) ◽  
pp. 3939
Author(s):  
Anju Dogra ◽  
Vinay Kumar ◽  
Nishu Bhushan
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Wound Infection ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Laparoscopic hysterectomy has become a widely accepted technique worldwide, since its introduction by Reich in 1989. The aim of the study was to compare the surgical results and intra- operative and post-operative complications between total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH).Methods: Authors conducted a retrospective study at SMGS hospital, GMC Jammu between October 2016 to September 2018, 126 patients who underwent TLH and 126 patients who underwent TAH, were included.Results: Authors observed that there was no significant difference between the two groups in respect to patient’s age, parity and indication of surgery. Duration of surgery was found to be longer in TLH than TAH. The length of hospital stay was less in TLH than TAH. Hb drop was more in TAH group. 25 patients of TAH were given post op blood transfusion but only 9 patients of TLH were given post op blood transfusion. The time to ambulation in patients of TLH was much shorter than TAH. Wound infection was more common in TAH as compared to TLH, 5 patients had wound infection and in 4 patients resuturing was done for wound dehiscence. In 8 patients laparoscopy was converted to laparotomy because of adhesions, vascular injury and in one case because of bowel injury.Conclusions: This study showed that TLH can be safely performed by the experienced surgeon as an alternative to abdominal hysterectomy. It offers several benefits over TAH such as smaller incision, earlier ambulation, shorter hospital stay, faster recovery time and does not increase more serious complications than TAH.

scholarly journals Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Carbonnel ◽  
H. Abbou ◽  
H. T. N’Guyen ◽  
S. Roy ◽  
G. Hamdi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Benign Disease ◽  
Post Surgery ◽  
A Prospective Study

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus  min; ). Blood loss and length of hospital stay were significantly reduced: versus  ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

scholarly journals African experiences of laparoscopic hysterectomy about a continuous series of 52 cases by the same practitioner: indications, surgical procedures and complications

2018 ◽  
Vol 7 (3) ◽  
pp. 789
Author(s):  
Koffi Abdoul Koffi ◽  
Kacou Edele Aka ◽  
Minata Fomba ◽  
Konan Seni ◽  
Apollinaire Horo ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Average Length ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Pelvic Surgery ◽  
Continuous Series ◽  
Average Size ◽  
A Prospective Study

Background: Laparoscopy is a modern surgical technique that began in 1940 with Raoul Palmer. The present study aimed to analyse the results of a fifty-two-laparoscopic hysterectomy performed.Methods: A prospective study over a period of seven years from 1st January 2010 to 31st December 2015. A total of 52 patients who underwent a laparoscopic hysterectomy were recruited at the teaching hospital of Yopougon-Abidjan.Results: The mean age was 50.2 years (±3.9 years) (36-62 years). The average parity was 3. Few patients had undergone anterior pelvic surgery for either myomectomy or caesarean section. Uterine fibroid was the major surgical indication with a rate of 61.54%. The average size of the uterus was 12 cm (8-18 cm). Total hysterectomies type II and III with or without adnexectomy were essentially performed with rates of 28.85% and 32.69%, respectively. Sometimes it was associated with a lymphadenectomy or a colpo-suspension. The average length of a hysterectomy is 170 minutes (87-385 minutes). Four cases of laparo-conversions have been noted. Blood loss was approximately 95 ml (±12 ml) with a maximum of 300 ml. The complications were mainly two digestive wounds and a bladder fistula. The average length of hospital stay is three days apart from any complication.Conclusions: The laparoscopic approach is less painful, is associated with less blood loss, shorter hospital stay, faster recovery, fewer complications, and better care. A training period of surgeons associated with the equipment of the health structures is necessary to popularize this procedure surgical.

Neurogenic claudication associated with posterior vertebral rim fractures in children

2012 ◽  
Vol 10 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Jonathan G. Thomas ◽  
Jerome Boatey ◽  
Alison Brayton ◽  
Andrew Jea
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Leg Pain ◽  
Neurogenic Claudication ◽  
Pediatric Age Group ◽  
Fractures In Children ◽  
The Mean

Object Outside of the patient population with achondroplasia, neurogenic claudication is rare in the pediatric age group. Neurogenic claudication associated with posterior vertebral rim fracture is even more uncommon but nonetheless causes pain and disability in affected children and adolescents. The purpose of this study was to describe the surgical results of 3 adolescents presenting with neurogenic claudication and posterior vertebral rim fracture when treated with laminectomy alone. Methods The medical and operative records of the 3 pediatric patients were retrospectively reviewed. Presenting signs and symptoms and CT findings, such as the interpedicular distances between T-12 and L-5, were obtained. Perioperative results were assessed, including operative time, blood loss, length of hospital stay, and complications. Findings at latest follow-up were also recorded, including a patient satisfaction survey. Results The 3 patients (1 girl and 2 boys) had a mean age of 14.7 years (range 14–15 years) and underwent follow-up for a mean of 11.3 months (range 5–18 months). Notable preoperative signs and symptoms included back pain (all patients), leg pain (all patients), leg numbness (1 patient), and leg weakness (1 patient). No patient presented with bowel and/or bladder dysfunction. The mean blood loss during laminectomy was 123 ml (range 20–300 ml), and the mean length of hospital stay was 4.3 days (range 3–6 days). On average, decompression was performed at 2.2 levels (range 2–2.5 levels). All 3 patients reported at most recent follow-up that they were “satisfied” with the surgery. There was 1 complication of instability from an iatrogenic pars fracture, which required reoperation and posterior instrumented fusion. Conclusions To the best of the authors' knowledge, this report represents the first surgical series of pediatric neurogenic claudication associated with posterior vertebral rim fractures. Pediatric neurosurgeons may infrequently encounter neurogenic claudication associated with a posterior vertebral rim fracture in children. To treat children with neurogenic claudication associated with posterior vertebral rim fractures, a simple laminectomy may be a safe and efficacious alternative to discectomy and removal of fracture fragments.

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