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Clinical outcomes of hysterectomy for benign diseases in the female genital tract: 6 years’ experience in a single institute

Yeungnam University Journal of Medicine 2020년 37권 4호 p.308 ~ 313
김효신, 구유진, 이대형,
소속 상세정보
김효신 ( Kim Hyo-Shin ) - Yeungnam University Hospital Department of Obstetrics and Gynecology
구유진 ( Koo Yu-Jin ) - Yeungnam University Hospital Department of Obstetrics and Gynecology
이대형 ( Lee Dae-Hyung ) - Yeungnam University College of Medicine Department of Obstetrics and Gynecology

Abstract


Background: Hysterectomy is one of the major gynecologic surgeries. Historically, several surgical procedures have been used for hysterectomy. The present study aims to evaluate the surgical trends and clinical outcomes of hysterectomy performed for benign diseases at the Yeungnam University Hospital.

Methods: We retrospectively reviewed patients who underwent a hysterectomy for benign diseases from 2013 to 2018. Data included the patients’ demographic characteristics, surgical indications, hysterectomy procedures, postoperative pathologies, and perioperative outcomes.

Results: A total of 809 patients were included. The three major indications for hysterectomy were uterine leiomyoma, pelvic organ prolapse, and adenomyosis. The most common procedure was total laparoscopic hysterectomy (TLH, 45.2%), followed by open hysterectomy (32.6%). During the study period, the rate of open hysterectomy was nearly constant (29.4%?38.1%). The mean operative time was the shortest in the single-port laparoscopic assisted vaginal hysterectomy (LAVH, 89.5 minutes), followed by vaginal hysterectomy (VH, 96.8 minutes) and TLH (105 minutes). The mean decrease in postoperative hemoglobin level was minimum in single-port LAVH (1.8 g/dL) and VH (1.8 g/dL). Conversion to open surgery or multi-port surgery occurred in five cases (0.6%). Surgical complications including wound dehiscence, organ injuries, and conditions requiring reoperation were observed in 52 cases (6.4%).

Conclusion: Minimally invasive approach was used for most hysterectomies for benign diseases, but the rate of open hysterectomy has mostly remained constant. Single-port LAVH and VH showed the most tolerable outcomes in terms of operative time and postoperative drop in hemoglobin level in selected cases.

키워드

Female genital disease; Gynecological surgical procedures; Hysterectomy; Minimally invasive surgical procedures

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