Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e Obstetrícia
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000400005 |
Resumo: | Laparoscopic and vaginal routes are the preferable routes to consider when planning a hysterectomy. Laparoscopy brings advantages to vaginal route when there are concomitant adnexal masses, endometriosis, pelvic inflammatory disease or previous abdominal surgeries. However, the learning curve in laparoscopy is slower and the surgery itself is, consequently, very dependent on the surgeon's experience. In this article, the authors review the first 300 total laparoscopic hysterectomy (TLH) surgeries in a new Obstetric/Gynecology Department. A retrospective analysis to clinical files of patients submitted to TLH between January 2013 and February 2016. Data was divided in 2 groups: group A, corresponding to the first 150 HTL and group B, with the 150 subsequent HTL. The results showed 2 similar groups, with median ages of 51 years old, with 27 median corporeal mass index, with 41% of the patients having previous abdominal surgeries. The main surgical indication was anomalous uterine bleeding secondary to mioma/adenomyosis (53%), and 309 concomitant surgeries were performed during surgical time (the majority in the adnexal area, 84%). Globally the intra-operatory and post-operatory complications rate was 1% and 2.3%, respectively, and most occurred in group A. The conversion rate to laparotomy or vaginal assisted laparoscopic hysterectomy was low (2.3%), and was only verified in group A, with statistic significance (p-value - 0.024). The blood loss volume was also statiscally different between the 2 groups (p-value < 0.001), with less volume blood loss in group B. The average uterine weight was similar in the 2 groups, with 187 and 168 grams, and the average surgical time was 155 and 148 minutes, which included the concomitant surgeries. In conclusions, despite the small number of cases, our study seems to show a tendency towards decrease in complications rate, conversion rate and blood loss, probably due to increased experience of the surgeons |
id |
RCAP_e6b0a2ac99740937d285317190299243 |
---|---|
oai_identifier_str |
oai:scielo:S1646-58302017000400005 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e ObstetríciaHisterectomyLaparoscopyComplicationsLaparoscopic and vaginal routes are the preferable routes to consider when planning a hysterectomy. Laparoscopy brings advantages to vaginal route when there are concomitant adnexal masses, endometriosis, pelvic inflammatory disease or previous abdominal surgeries. However, the learning curve in laparoscopy is slower and the surgery itself is, consequently, very dependent on the surgeon's experience. In this article, the authors review the first 300 total laparoscopic hysterectomy (TLH) surgeries in a new Obstetric/Gynecology Department. A retrospective analysis to clinical files of patients submitted to TLH between January 2013 and February 2016. Data was divided in 2 groups: group A, corresponding to the first 150 HTL and group B, with the 150 subsequent HTL. The results showed 2 similar groups, with median ages of 51 years old, with 27 median corporeal mass index, with 41% of the patients having previous abdominal surgeries. The main surgical indication was anomalous uterine bleeding secondary to mioma/adenomyosis (53%), and 309 concomitant surgeries were performed during surgical time (the majority in the adnexal area, 84%). Globally the intra-operatory and post-operatory complications rate was 1% and 2.3%, respectively, and most occurred in group A. The conversion rate to laparotomy or vaginal assisted laparoscopic hysterectomy was low (2.3%), and was only verified in group A, with statistic significance (p-value - 0.024). The blood loss volume was also statiscally different between the 2 groups (p-value < 0.001), with less volume blood loss in group B. The average uterine weight was similar in the 2 groups, with 187 and 168 grams, and the average surgical time was 155 and 148 minutes, which included the concomitant surgeries. In conclusions, despite the small number of cases, our study seems to show a tendency towards decrease in complications rate, conversion rate and blood loss, probably due to increased experience of the surgeonsEuromédice, Edições Médicas Lda.2017-10-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000400005Acta Obstétrica e Ginecológica Portuguesa v.11 n.4 2017reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000400005Caeiro,FilipaMiranda,MarianaNogueira,BrunoMendinhos,GustavoPereira,Ana PaulaReis,JoséFaustino,FátimaVeríssimo,Carlosinfo:eu-repo/semantics/openAccess2024-02-06T17:21:39Zoai:scielo:S1646-58302017000400005Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:28:36.951919Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e Obstetrícia |
title |
Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e Obstetrícia |
spellingShingle |
Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e Obstetrícia Caeiro,Filipa Histerectomy Laparoscopy Complications |
title_short |
Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e Obstetrícia |
title_full |
Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e Obstetrícia |
title_fullStr |
Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e Obstetrícia |
title_full_unstemmed |
Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e Obstetrícia |
title_sort |
Histerectomia totalmente laparoscópica: as primeiras 300 de um novo serviço de Ginecologia e Obstetrícia |
author |
Caeiro,Filipa |
author_facet |
Caeiro,Filipa Miranda,Mariana Nogueira,Bruno Mendinhos,Gustavo Pereira,Ana Paula Reis,José Faustino,Fátima Veríssimo,Carlos |
author_role |
author |
author2 |
Miranda,Mariana Nogueira,Bruno Mendinhos,Gustavo Pereira,Ana Paula Reis,José Faustino,Fátima Veríssimo,Carlos |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Caeiro,Filipa Miranda,Mariana Nogueira,Bruno Mendinhos,Gustavo Pereira,Ana Paula Reis,José Faustino,Fátima Veríssimo,Carlos |
dc.subject.por.fl_str_mv |
Histerectomy Laparoscopy Complications |
topic |
Histerectomy Laparoscopy Complications |
description |
Laparoscopic and vaginal routes are the preferable routes to consider when planning a hysterectomy. Laparoscopy brings advantages to vaginal route when there are concomitant adnexal masses, endometriosis, pelvic inflammatory disease or previous abdominal surgeries. However, the learning curve in laparoscopy is slower and the surgery itself is, consequently, very dependent on the surgeon's experience. In this article, the authors review the first 300 total laparoscopic hysterectomy (TLH) surgeries in a new Obstetric/Gynecology Department. A retrospective analysis to clinical files of patients submitted to TLH between January 2013 and February 2016. Data was divided in 2 groups: group A, corresponding to the first 150 HTL and group B, with the 150 subsequent HTL. The results showed 2 similar groups, with median ages of 51 years old, with 27 median corporeal mass index, with 41% of the patients having previous abdominal surgeries. The main surgical indication was anomalous uterine bleeding secondary to mioma/adenomyosis (53%), and 309 concomitant surgeries were performed during surgical time (the majority in the adnexal area, 84%). Globally the intra-operatory and post-operatory complications rate was 1% and 2.3%, respectively, and most occurred in group A. The conversion rate to laparotomy or vaginal assisted laparoscopic hysterectomy was low (2.3%), and was only verified in group A, with statistic significance (p-value - 0.024). The blood loss volume was also statiscally different between the 2 groups (p-value < 0.001), with less volume blood loss in group B. The average uterine weight was similar in the 2 groups, with 187 and 168 grams, and the average surgical time was 155 and 148 minutes, which included the concomitant surgeries. In conclusions, despite the small number of cases, our study seems to show a tendency towards decrease in complications rate, conversion rate and blood loss, probably due to increased experience of the surgeons |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-10-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000400005 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000400005 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000400005 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Euromédice, Edições Médicas Lda. |
publisher.none.fl_str_mv |
Euromédice, Edições Médicas Lda. |
dc.source.none.fl_str_mv |
Acta Obstétrica e Ginecológica Portuguesa v.11 n.4 2017 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799137355765907456 |