COMPARISON OF COMPLICATIONS BY UTERINE WEIGHT IN TOTAL LAPAROSCOPIC HYSTERECTOMY
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Objective To evaluate the potential effect of uterine weight on short-term outcome and incidence of complications after total laparoscopic hysterectomy (TLH) for a benign gynecologic disease. Methods A retrospective medical record review of 771 cases where TLH was performed. Patients included in this study underwent TLH for either myoma or adenomyosis at Gil Hospital, Gachon University of Medicine and Science, from March 2006 through December 2010. Participating patients were stratifi ed into three groups: group 1 with uterine weight less than 250 g (n = 435), group 2 with uterine weight 250 to 500 g (n = 272), and group 3 with uterine weight more than 500 g (n = 64). The groups were compared based on total operation time, estimated blood loss, length of postoperative hospital stay, observations of postoperative complications,and rate of conversion from to TLH to laparotomy. Results We discovered no statistical difference between the three groups in terms of overall postoperative complications or short-term surgical outcomes. Major complications such as ureter injury and necessity for reoperation occurred in each group. Operation time and estimated blood loss increased slightly as uterine weight increased, but, there was no statistical signifi cance. Conclusion TLH can be successfully performed, even in cases of enlarged uterus. Patients with an enlarged uterus are suitable candidates for TLH.
Abstract
Objective To evaluate the potential effect of uterine weight on short-term outcome and incidence of complications after total laparoscopic hysterectomy (TLH) for a benign gynecologic disease. Methods A retrospective medical record review of 771 cases where TLH was performed. Patients included in this study underwent TLH for either myoma or adenomyosis at Gil Hospital, Gachon University of Medicine and Science, from March 2006 through December 2010. Participating patients were stratifi ed into three groups: group 1 with uterine weight less than 250 g (n = 435), group 2 with uterine weight 250 to 500 g (n = 272), and group 3 with uterine weight more than 500 g (n = 64). The groups were compared based on total operation time, estimated blood loss, length of postoperative hospital stay, observations of postoperative complications,and rate of conversion from to TLH to laparotomy. Results We discovered no statistical difference between the three groups in terms of overall postoperative complications or short-term surgical outcomes. Major complications such as ureter injury and necessity for reoperation occurred in each group. Operation time and estimated blood loss increased slightly as uterine weight increased, but, there was no statistical signifi cance. Conclusion TLH can be successfully performed, even in cases of enlarged uterus. Patients with an enlarged uterus are suitable candidates for TLH.
참고문헌 (14)
- Nezhat F, "Laparoscopic versus abdominal hysterectomy", J Reprod Med, 37, pp.247~250 (1992)
- Reich H, "Peritoneal trophoblastic tissue implants after laparoscopic treatment of tubal ectopic pregnancy", Fertil Steril, 52, pp.337~339 (1989)
- David-Montefi ore E, "Collegiale d’Obstétrique et Gynécologie de Paris-Ile de France. Surgical routes and complications of hysterectomy for benign disorders: a prospective observational study in French university hospitals", Hum Reprod, 22, pp.260~265 (2007)
- Reich H, "Laparoscopic hysterectomy", Baillieres Clin Obstet Gynaecol, 8, pp.799~815 (1994)
- Boike GM, "Laparoscopically assisted vaginal hysterectomy in a university hospital: report of 82 cases and comparison with abdominal and vaginal hysterectomy", Am J Obstet Gynecol, 168, pp.1690~1697 (1993)
- Davies A, "Hysterectomy: surgical route and complications", Eur J Obstet Gynecol Reprod Biol, 104, pp.148~151 (2002)
- Wattiez A, "Total laparoscopic hysterectomy for very enlarged uteri", J Am Assoc Gynecol Laparosc, 9, pp.125~130 (2002)
- Feroze RM, "Vaginal hysterectomy and repair", Clin Obstet Gynaecol, 5, pp.545~556 (1978)
- Hillis SD, "Uterine size and risk of complications among women undergoing abdominal hysterectomy for leiomyomas", Obstet Gynecol, 87, pp.539~543 (1996)
- Fiaccavento A, "Total laparoscopic hysterectomy in cases of very large uteri: a retrospective comparative study", J Minim Invasive Gynecol, 14, pp.559~563 (2007)
- Sinha R, "Total laparoscopic hysterectomy for large uterus", J Gynecol Endos Surgery, 1, pp.34~39 (2009)
- 권형준, "복강경하 전자궁절제술에서 자궁의 무게에 따른 이환율의 비교", Obstetrics & Gynecology Science, 53(01), pp.53~57 (2010), 대한산부인과학회
- Olive DL, "The AAGL classifi cation system for laparoscopic hysterectomy. Classifi cation committee of the American Association of Gynecologic Laparoscopists", J Am Assoc Gynecol Laparosc, 7, pp.9~15 (2000)
- Ng CC, "Total laparoscopic hysterectomy: a 5-year experience", Arch Gynecol Obstet, 276, pp.613~618 (2007)