Safety of total laparoscopic hysterectomy in a high complexity Hospital in Pereira, Colombia, between 2007 and 2017. Cohort study
DOI:
https://doi.org/10.18597/rcog.3530Abstract
Objective: To describe intra- and postoperative complications of total laparoscopic hysterectomy (TLH) for benign uterine pathology and to compare with other hospitals with large volumes of laparoscopic hysterectomies. Materials and Methods: Retrospective cohort study of women who underwent TLH for benign gynecological pathology between 2007 and 2017 in a private intermediate complexity institution that serves populations covered by contributive and state-subsidized insurance in Pereira, Colombia. The procedures were performed by the group of surgeons of the ALGIA training center. Consecutive sampling was used. Sociodemographic and baseline clinical characteristics, intra-operative findings and intra- and post-operative complications are described. Descriptive statistics were used. Results: A total of 1350 patients were included during the study period. Surgical time was 95 minutes (SD ± 31), blood loss 88 cc (SD ± 66), and average uterine weight was 236 g (SD ± 133); 96.5% of the patients were assessed within the next 30 to 45 days; 3.48% had minor complications and 2.5% had major complications; 3 patients were converted to laparotomy. There were no deaths in the study sample. Conclusion: TLH is a safe procedure and the rate of complications is similar to the best international standards. Further prospective studies using objective criteria are important in order to compare the performance of different groups and institutions offering surgical procedures and training.
Author Biographies
Claudia Bastidas-Guarín, Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia).
Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia); Clínica Comfamiliar, Pereira (Colombia).
Claudia Patricia Zambrano-Moncayo, Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA
Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia); Clínica Comfamiliar, Pereira (Colombia).
Jorge Darío López-Isanoa , Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia).
Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia); Clínica Comfamiliar, Pereira (Colombia).
José Duván López-Jaramillo, Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia).
Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia); Clínica Comfamiliar, Pereira (Colombia).
Ana Lucía Herrera-Betancourt, Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia).
Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia); Clínica Comfamiliar, Pereira (Colombia).
Angélica Cuello-Salcedo, Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia).
Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia); Clínica Comfamiliar, Pereira (Colombia).
Eliana Gutiérrez-Calderón, Clínica Comfamiliar, Pereira (Colombia).
Clínica Comfamiliar, Pereira (Colombia); Fundación Universitaria Área Andina, Pereira (Colombia).
Danny Leandro Piedrahíta-Gutiérrez, Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia).
Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia); Clínica Comfamiliar, Pereira (Colombia).
Juan Diego Villegas-Echeverri, Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia).
Unidad de laparoscopia ginecológica avanzada y dolor pélvico – ALGIA, Pereira (Colombia); Clínica Comfamiliar, Pereira (Colombia).
References
Gante I, Medeiros-Borges C, Águas F. Hysterectomies in Portugal (2000-2014): What has changed? Eur J Obstet Gynecol Reprod Biol. 2017;208:97-102. http://doi.org/10.1016/j.ejogrb.2016.11.021.
Fingar KR, Stocks C, Weiss AJ, Steiner CA. Most frequent operating room procedures performed in U.S. hospitals, 2003-2012: Statistical Brief #186. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014.
Turner LC, Shepherd JP, Wang L, Bunker CH, Lowder JL. Hysterectomy surgery trends: A more accurate depiction of the last decade? Am J Obstet Gynecol. 2013;208(4):277.e1-277.e2777. http://doi.org/10.1016/j.ajog.2013.01.022.
Reich H, DeCaprio J, McGlynn F. Laparoscopic hysterectomy. J Gynecol Surg. 1989;5:213-6. http://doi.org/10.1089/gyn.1989.5.213.
Lee SH, Oh SR, Cho YJ, Han M, Park JW, Kim SJ, et al. Comparison of vaginal hysterectomy and laparoscopic hysterectomy: A systematic review and meta-analysis. BMC Womens Health. 2019;19(1):83. http://doi.org/10.1186/s12905-019-0784-4.
Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW, Kluivers KB. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2015;(8):CD003677. http://doi.org/10.1002/14651858.CD003677.pub5.
Dedden SJ, Geomini PMAJ, Huirne JAF, Bongers MY. Vaginal and laparoscopic hysterectomy as an outpatient procedure: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2017;216:212-23. http://doi.org/10.1016/j.ejogrb.2017.07.015.
Hwang JL, Seow KM, Tsai YL, Huang LW, Hsieh BC, Lee C. Comparative study of vaginal, laparoscopically assisted vaginal and abdominal hysterectomies for uterine myoma larger than 6 cm in diameter or uterus weighing at least 450 g: A prospective randomized study. Acta Obstet Gynecol Scand. 2002;81(12):1132-38. http://doi.org/10.1034/j.1600-0412.2002.811206.x.
Mäkinen J, Brummer T, Jalkanen J, Heikkinen AM, Frasser J, Tomas E, et al. Ten years of progress—improved hysterectomy outcomes in Finland 1996-2006: A longitudinal observation study. BMJ Open. 2013;3(10):e003169. http://doi.org/10.1136/bmjopen-2013-003169.
Barber EL, Harris B, Gehrig PA. Trainee participation and perioperative complications in benign hysterectomy: The effect of route of surgery. Am J Obstet Gynecol. 2016;215(2):215.e1-215.e2157. http://doi.org/10.1016/j.ajog.2016.02.022.
Driessen SR, van Zwet EW, Haazebroek P, Sandberg EM, Blikkendaal MD, Twijnstra AR, et al. A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes. Am J Obstet Gynecol. 2016;215(6):754 e1-754 e8. http://doi.org/10.1016/j.ajog.2016.07.004.
Alfa-Wali M, Osaghae S. Practice, training and safety of laparoscopic surgery in low and middle-income countries. World J Gastrointest Surg. 2017;9(1):1318. http://doi.org/10.4240/wjgs.v9.i1.13
Einarsson JI, Suzuki Y. Total laparoscopic hysterectomy: 10 steps toward a successful procedure. Rev Obstet Gynecol. 2009;2(1):57-64.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-13. http://doi.org/10.1097/01.sla.0000133083.54934.ae.
De los Ríos JF, Castañeda JD, Calle GA, Serna E, Vásquez RA, Arango AM, et al. Histerectomía laparoscópica total en la unidad de endoscopia ginecológica de la Clínica del Prado, Medellín (Colombia), 2002-2008. Rev Colomb Obstet Ginecol. 2009;60(4):320-7. https://doi.org/10.18597/rcog.314
Navarro-Newball H. Histerectomía laparoscópica: Sistematización del procedimiento y propuesta para programas de capacitación. Colomb Med. 2005;36(2):115-9. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1657-95342005000200009&lng=en
Wright JD, Ananth CV, Lewin SN, Burke WM, Lu YS, Neugut AI, et al. Robotically assisted vs laparoscopic hysterectomy among women with benign gynecologic disease. JAMA. 2013;309(7):689-98. http://doi.org/10.1001/jama.2013.186.
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