Total laparoscopic hysterectomy at the Clínica del Prado’s Gynaecological Endoscopy Unit in Medellín, Colombia 2002 - 2008
DOI:
https://doi.org/10.18597/rcog.314Keywords:
total laparoscopic hysterectomy, complication, surgical timeAbstract
Objective: describing accumulated experience gained from performing Total Laparoscopic Hysterectomy (TLH) at the Clínica del Prado.
Methodology: this was a descriptive, retrospective study (evidence level III) which involved patients who underwent TLH in the Gynaecological Endoscopic Unit at Clínica del Prado, Medellín, Colombia.1,150 medical records from patients operated on between December 2002 and April 2008 were reviewed; those in which at least 90% of the data required by a predesigned instrument could be recovered were included for analysis. Main outcomes measured: demographic data, surgical indication, laparoconversion rate and causes, surgical time, estimated blood loss, uterine weight and height, time of hospital stay and complications.
Results: 837 patients were included; TLH was entirely performed on 822 of them by laparoscopy whilst 15 (1.7%) required laparoconversion. The most frequent indications for surgery were fibroids (43.8%) and abnormal uterine bleeding (36.1%). Mean age was 42.7. 83.8% of the patients were ASA I (American Society of Anesthesiologists); the main comorbidity found was hypertension (9.9%). Mean surgical time was 85.9 minutes; mean estimated blood loss was 60.6 mL. The commonest histological diagnosis was fibroids (57.1%). Mean uterine weight was 180 grams and mean uterine height 10.2 cm. Complications affected 12.5% of the 837 patients, 3.1% of them being major ones.
Conclusions: TLH is a safe and replicable procedure. It requires a short hospital stay and has a low complication rate, similar to that found in the literature.
Author Biographies
José F. De Los Ríos
Juan D. Castañeda
Gustavo A. Calle
Eduardo Serna
Ricardo A. Vásquez
Adriana M. Arango
Orlando J. Flórez
Ana M. Mejía
Victoria Arango
Tatiana Palacio
References
Reich H, Maher PJ, Wood C. Laparoscopic hysterectomy. Baillieres Clin Obstet Gynaecol 1994;8:799-815.
Johnson N, Barlow D, Lethaby A, Tavender E, Curr E. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database of Systematic Reviews 2006, Issue 2.
Garry R, Fountain J, Mason S, Hawe J, Napp V, Abbot J, et al. The eVALuate study: two parallel randomized trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ 2004;328:129.
Celis A, Sandoval I. Histerectomía laparoscópica total: una nueva alternativa en cirugía endoscópica. Ginecol Obstet Perú 2001;47:27-36.
Argüello R, Hoyos E, Argüello R, Perdomo P. Histerectomía total por laparoscopia en 202 pacientes. Rev Colomb Obstet Ginecol 2003;54:258-64.
Corvalán A, Roos A, Lattus J, Barrera V, Gallardo A, Flores J, et al. Histerectomía laparoscópica: resultados en 3 años de desarrollo de la técnica utilizando el manipulador uterino de Clermont Ferrand. Rev Chil Obstet Ginecol 2004;69:446-50.
Navarro-Newball H. Histerectomía laparoscópica: sistematización del procedimiento y propuesta para programas de capacitación. Colomb Med 2005;36:115-9.
Suárez C, Mijares A, Briceño J, Calderaro Di Ruggiero-F, Medina F, Anzola F, et al. Introducción de la histerectomía laparoscópica en un servicio de ginecología oncológica. Rev Venez Oncol 2006;18:152-7.
Ortiz FM, López MA, Elorriaga E, Soto JM, Lelevier HB. Histerectomía total laparoscópica: complicaciones y evolución clínica en una serie de 87 casos. Ginecol Obstet Mex 2008;76:520-5
O’Hanlan KA, Dibble SL, Garnier AC, Reuland ML. Total laparoscopic hysterectomy: technique and complications of 830 cases. JSLS 2007;11:45-53
Boyd ME, Groome PA. The morbidity of abdominal hysterectomy. Can J Surg 1993;36:155-9.
Iftkikhar R. Vaginal hysterectomy is superior than abdominal hysterectomy. J Surg Pak 2008;13:55-8.
SalinasH, Pastén J, Naranjo B, Carmona S, Retamales B, Díaz G, et al. Análisis clínico y económico de la histerectomía vaginal en el hospital clínico de la Universidad de Chile. Revisión de 2338 casos. Rev Chil Obstet Ginecol 2006;71:227-33.
Kayastha S, Tuladhar H. Vaginal hysterectomy vs. abdominal hysterectomy. Last updated: april 22, 2009. Visitado en 2009 Nov 8. Disponible en: http://www.nmcth.edu/nmcj_articles_pdf/volume_wise/nmcj_vol8_no4/Sanita_Kayatha.pdf
How to Cite
Downloads
Downloads
Published
Issue
Section
License
Copyright (c) 2016 Revista Colombiana de Obstetricia y Ginecología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Article metrics | |
---|---|
Abstract views | |
Galley vies | |
PDF Views | |
HTML views | |
Other views |