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- Title
Hysterectomy for Benign Lesions: What Is Left for the Abdominal Route?
- Authors
Cosson, Michel; Boukerrou, Malik; Lambaudie, Eric; Narducci, Fabrice; Crépin, Gilles
- Abstract
The object of this study was to determine the indications for abdominal hysterectomy and their complications, in a prospective series of 453 hysterectomies for benign lesions that were performed between April 4, 1996 and December 14, 1998 in the authors' institution. Most of hysterectomies were vaginal (72.85%) or laparoscopic-assisted (15.67%) procedures. Ten of them had to be converted to abdominal procedures because of extensive adhesions or limited vaginal access. The vaginal route was used whenever possible. The authors' most important selection criteria are of the weight uterus (estimated on scan), vaginal access (estimated by clinic examination preoperatively and intraoperatively), and pelvic surgery history of the patient. The abdominal route was selected when either vaginal or laparoscopic-assisted procedures proved impossible to be performed, the operating time was longer (130 minutes), intraoperative bleeding was higher (504 mL), and the mean hospital stay was 6.4 days. The perioperative complications, including bladder and small intestine lesions or hemorrhages, were 11.5%. The mean uterus weight was 612 g. The authors noted 11.9% postoperative complications. Laparotomies (11.47%) still proved necessary in cases of prior abdominal or pelvic surgery with large uterus volume and/or poor vaginal access. The laparotomy rate decreased with experience, but this study evidenced several technical difficulties inherent in the abdominal procedure as well as a higher number of intraoperative and postoperative complications that had to be dealt with by skilled operators.
- Subjects
PRECANCEROUS conditions; HYSTERECTOMY; LAPAROSCOPY
- Publication
Journal of Gynecologic Surgery, 2001, Vol 17, Issue 4, p109
- ISSN
1042-4067
- Publication type
Article
- DOI
10.1089/104240601317207075