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Choudhary A, Palaskar PA, Bhivsane V. Complications of total laparoscopic hysterectomy: A retrospective study of cases performed by a single surgeon. J Minim Access Surg 2023; 19:473-477. [PMID: 37282419 PMCID: PMC10695312 DOI: 10.4103/jmas.jmas_148_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/18/2022] [Accepted: 08/28/2022] [Indexed: 03/19/2023] Open
Abstract
Hysterectomy is the most common gynaecological surgery and there are different techniques of performing hysterectomy. With the advent of laparoscopic technology, laparoscopic hysterectomy (LH) is rapidly gaining its ground. However, every surgery has its complications which are specific but also depends on various factors such as surgical sk[ills and experience of surgeons, levels of operative laparoscopy and patient populations. Aims and Objective In this study, we evaluated the complications of total laparoscopic hysterectomy (TLH) and analysed the trend of complications, intraoperative and post-operative, over a period of time. Methods It was a retrospective study conducted in the private care setting. All women who underwent hysterectomy for benign conditions from a 1 January 2003 to 31 December 2017, (15 years) were included in this study. A total of 3272 patients were operated during this period. All surgeries were performed by a single surgeon. Results Intraoperative complications that occurred during surgery during the study period were 3 cases (0.09%) had bladder injury, 3 cases (0.09%) had bowel injury, 1 case (0.03%) had internal iliac vessel bleeding and 1 case(0.03%) needed conversion to vaginal hysterectomy due to cautery failure and post operative complications were 90 cases (2.75%) had vault bleeding, 2 cases (0.06%) had intestinal obstruction, 5 cases (0.15%) had paralytic ileus, 1 case (0.03%) had vesicovaginal fistula, 1 case(0.03%) had ureterovaginal fistula and 1 case (0.03%) had peritonitis. Conclusions TLH is a very effective, patient-friendly and safe technique in the hands of experienced surgeons giving good quality of life to patients postoperatively.
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Affiliation(s)
- Amruta Choudhary
- Department of OBGY, Datta Meghe Medical College, Nagpur, Maharashtra, India
| | - Pandit A. Palaskar
- Department of OBGY, Endoworld Hospital Pvt. Ltd., Aurangabad, Maharashtra, India
| | - Vinod Bhivsane
- Department of OBGY, Endoworld Hospital Pvt. Ltd., Aurangabad, Maharashtra, India
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Comparison of the Effects of Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy on Sexual Function and Quality of Life. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8247207. [PMID: 33376741 PMCID: PMC7738778 DOI: 10.1155/2020/8247207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/04/2020] [Accepted: 12/01/2020] [Indexed: 11/17/2022]
Abstract
It is known that benign gynecological diseases negatively affect sexual function. For this reason, hysterectomy provides improvement in sexual function as well as symptoms such as bleeding and pain. The effects of abdominal hysterectomy (TAH) and laparoscopic hysterectomy (TLH), which are the two most common types of hysterectomy today, are not clear. In our study, we investigated the effects of TAH and TLH on sexual function and quality of life as well as intraoperative and postoperative results. In 329 TLH and 126 TAH patients, we compared both and between themselves preoperatively and postoperatively by using the standardized and validated female sexual function index (FSFI) and European quality of life five-dimension scale (EQ-5D). In conclusion, we found that both types of hysterectomy were effective in improving sexual function, and we concluded that improvement in the laparoscopy group was statistically higher. Patients who require hysterectomy for benign gynecological reasons should be informed that TLH has a more positive effect on sexual function as well as other advantages, and if the patients' main complaint is sexual dysfunction, TLH should be preferred compared to TAH.
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He H, Yang Z, Zeng D, Fan J, Hu X, Ye Y, Bai H, Jiang Y, Lin Z, Lei Z, Li X, Li L, Gan J, Lan Y, Tang X, Wang D, Jiang J, Wu X, Li M, Ren X, Yang X, Liu M, Wang Q, Jiang F, Li L. Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China. Chin J Cancer Res 2016; 28:187-96. [PMID: 27199516 PMCID: PMC4865611 DOI: 10.21147/j.issn.1000-9604.2016.02.06] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy (LH) compared with abdominal hysterectomy (AH) in case of benign gynecological disease. METHODS A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies (3,539 LH vs.1,356 AH) between 2007 and 2013 was involved. Operative time (OT), estimated blood loss (EBL), intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed. RESULTS The EBL (174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively), passing flatus (38.7±14.1 vs. 48.1±13.2 hours), days with indwelling catheter (1.5±0.6 vs. 2.2±0.8 days), use of analgesics (6.5% vs. 73.1%), intra-operative complication rate (2.4% vs. 4.1%), post-operative complication rate (2.3% vs. 5.7%), post-operative constipation (12.1% vs. 24.6%), mild and serious stress urinary incontinence (SUI) post-operative (P<0.001; P=0.014), and proportion of Female Sexual Functioning Index (FSFI) total score <26.55 post-operative (P<0.001) of the LH group were significantly less than those of AH group. There were no significant differences in OT (106.5±34.5 vs. 106.2±40.3 min) between the two groups. CONCLUSIONS LH is a safe and efficient operation for improving patients?long-term quality of life (QoL), and LH is a cost-effectiveness procedure for treating benign gynecological disease. LH is superior to AH due to reduced EBL, reduced post-operative pain and earlier passing flatus.
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Affiliation(s)
- Hongying He
- Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China
| | - Zhijun Yang
- Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China
| | - Dingyuan Zeng
- Department of Gynecological Oncology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China
| | - Jiangtao Fan
- Department of Gynecological and Obstetrics, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Xiaoxia Hu
- Department of Gynecological and Obstetrics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530022, China
| | - Yuan Ye
- Department of Gynecological and Obstetrics, The Affiliated Hospital of Guilin Medical University, Guilin 541004, China
| | - Hua Bai
- Department of Gynecological and Obstetrics, The Maternal & Child Health Hospital, Nanning 530003, China
| | - Yanming Jiang
- Department of Gynecological and Obstetrics, The People's Hospital of Liuzhou, Liuzhou 545006, China
| | - Zhong Lin
- Department of Gynecological and Obstetrics, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China
| | - Zhiying Lei
- Department of Gynecological and Obstetrics, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Xinlin Li
- Department of Gynecological and Obstetrics, Liuzhou Maternal & Child Health Hospital, Liuzhou 545000, China
| | - Lian Li
- Department of Gynecological and Obstetrics, The First People's Hospital of Nanning, Nanning 530000, China
| | - Jinghua Gan
- Department of Gynecological and Obstetrics, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Ying Lan
- Department of Gynecological and Obstetrics, The First Affiliated Hospital of Guangxi Technology University, Liuzhou 545000, China
| | - Xiongzhi Tang
- Department of Gynecological and Obstetrics, The People's Hospital of Guilin, Guilin 541002, China
| | - Danxia Wang
- Department of Gynecological and Obstetrics, The People's Hospital of Beihai, Beihai 536100, China
| | - Junsong Jiang
- Department of Gynecological and Obstetrics, The People's Hospital of Hechi, Hechi 546300, China
| | - Xiaoyan Wu
- Department of Gynecological and Obstetrics, The People's Hospital of Baise, Baise 533000, China
| | - Meiying Li
- Department of Gynecological and Obstetrics, The First People's Hospital of Yulin, Yulin 537000, China
| | - Xiaoqing Ren
- Department of Gynecological and Obstetrics, Wuzhou Worker's Hospital, Wuzhou 543001, China
| | - Xiaomin Yang
- Department of Gynecological and Obstetrics, The People's Hospital of Guigang, Guigang 537100, China
| | - Mei Liu
- Department of Gynecological and Obstetrics, The First People's Hospital of Qinzhou, Qinzhou 535001, China
| | - Qinmei Wang
- Department of Gynecological and Obstetrics, The Third People's Hospital of Liuzhou, Liuzhou 545007, China
| | - Fuyan Jiang
- Department of Gynecological and Obstetrics, Liuzhou Tumor Hospital, Liuzhou 545000, China
| | - Li Li
- Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China
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