When is laparotomy needed in hysterectomy for benign uterine disease?

被引:19
作者
Canis, Michel [1 ,3 ]
Botchorishvili, Revaz [1 ]
Ang, Catarina [2 ]
Rabischong, Benoit [1 ]
Jardon, Kris [1 ]
Wattiez, Arnaud [3 ]
Mage, Gerard [1 ]
机构
[1] CHU Clermont Ferrand, Dept Obstet Gynecol & Reprod Med, Policlin Hotel Dieu, F-63058 Clermont Ferrand, France
[2] Royal Hosp Women, Carlton, Vic, Australia
[3] CHU Strasbourg France, Ctr Med Chirurg & Obstetr Les Syndicates Interhos, Dept Obstet & Gynecol, Hautepierre Hosp, Strasbourg, France
关键词
hysterectomy; laparoscopy; benign uterine disease; complication;
D O I
10.1016/j.jmig.2007.09.003
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
Study Objective: We sought to study laparotomy (conversion and initial) and complication rates among patients who underwent hysterectomy initially performed laparoscopically whenever feasible. Design: A retrospective cohort study (Canadian Task Force classification II-3). Setting: University hospital. Patients: A continuous series of 680 patients, operated on between January 1, 2000, and December 31, 2003, was analyzed. Patients with malignancy and prolapse were excluded. Interventions: Hysterectomy. Measurements and Main Results: Overall, 7.2% of patients underwent laparotomy. In all, 27 (3.9%) patients were treated by initial laparotomy and 22 procedures were converted to laparotomy, 13 to laparoscopic-assisted vaginal hysterectomy (1.9%). Intraoperative and postoperative bladder complication rates were 0.8% and 0.4%, respectively. Ureteric complications were 0.3% and 0.4%, respectively, and bowel complications (bowel occlusion, peritonitis) were 0.4% and 0.4%, respectively. Three patients received blood transfusion. Of 19 patients who had repeated surgery for early or late postoperative complications, 13 were treated by laparoscopy and/or vaginally. Conclusion: Including management of complications, laparotomy was necessary in 8.1% of cases. Laparoscopic hysterectomy may be safely used in most patients.
引用
收藏
页码:38 / 43
页数:6
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