Intrafascial abdominal hysterectomy: outcomes and complications of 867 operations

Objective: To prospectively evaluate the results and complications of the surgical technique of intrafascial abdominal hysterectomy. Methods: From March 1993 to February 1998, 867 women at four institutions from the Department of Valle del Cauca, Colombia, underwent intrafascial abdominal hysterectomy. Information on sociodemographic and clinical characteristics before hysterectomy, indications for hysterectomy, surgical outcomes and intra- and post-operative complications were collected. Patients were evaluated at 1, 3, and 12 months post-operatively and annually thereafter. Results: The follow-up period ranged from 6 to 63 months (median = 45 months). The mean blood loss was 286 +/- 112 ml. Operative time averaged 71 +/- 11 min. The overall operative site infection rate was 4%. Intra- and post-operative hemorrhage occurred in 0.2 and 1.0% of patients, respectively. The transfusion rate was 0.7%. The incidences of ureteral, bladder, and bowel injury were 0.1, 0.4 and 0.0%, respectively. To date, none of the patients followed up between 1 and 5 years have had evidence of vaginal vault prolapse. Conclusions: Intrafascial abdominal hysterectomy is a safe technique with a low rate of complications. (C) 2000 International Federation of Gynecology and Obstetrics.