Our experience in laparoscopic hysterectomy: A single center experience

Yıl 2014, , 261 - 264, 01.06.2014

Ali Yavuzcan Mete Çağlar Gazi Yıldız Serdar Dilbaz Yusuf Üstün Onur Erişen Selahattin Kumru

https://doi.org/10.5799/ahinjs.01.2014.02.0399

Öz

Objective: The aim of this study is to compare the perioperative outcomes of first 30 Laparoscopic Hysterectomy operations (LH) with the subsequent ones in patients similar with basic demographic characteristics. Methods: A total of 92 patients operated in Bucak State Department of Obstetrics and Gynecology and Düzce University Hospital, Faculty of Medicine, Department of Obstetrics and Gynecology between January 2012 and October 2013 were included in this study. LH operations performed for the first time by the same surgeon in 30 patients were formed Group 1. The remaining 62 patients, operated after the first 30 patients were formed Group 2. Results: No statistically significant difference was detected in terms of age, parity, and previous history of pelvic surgery between Group 1 and Group 2 (p =0.813, p = 0.706 and p = 0.410). There was not any statistically significant difference between Group 1 and Group 2 in terms of operation time (min.), delta hb (g/dl), hospitalization time (day), and complication rate (p = 0.197 and p = 0.085, p = 0.086 and p = 0.353). Conclusion: As today LH is a promising method of operation with low complication rates and high patient satisfaction, it should be kept in mind that increased surgeon experience does not always assure good surgical outcome. J Clin Exp Invest 2014; 5 (2): 261-264

Anahtar Kelimeler

Experience, hysterectomy. laparoscopic

Laparoskopik histerektomi sonuçlarımız: Tek merkez deneyimi

Öz

Amaç: Bu çalışmanın amacı temel demografik özellikleri benzer olan hastalardan oluşan, ilk 30 Laparoskopik histerektomi (LH) operasyonu ve daha sonra yapılan 62 adet LH operasyonunun perioperatif sonuçlarını karşılaştırmaktır. Yöntemler: Çalışmamıza Bucak Devlet Hastanesi Kadın Hastalıkları ve Doğum Kliniği ile Düzce Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı\'nda Ocak 2012 ile Ekim 2013 tarihleri arasında opere edilen toplam 92 adet hasta dahil edilmiştir. Aynı cerrah tarafından LH operasyonu ilk defa uygulanmaya başlandıktan sonra yapılan ilk 30 hasta ile Grup 1 oluşturulmuştur. İlk 30 hastadan sonra opere edilen kalan 62 hasta ile Grup 2 oluşturulmuştur. Bulgular: Grup 1 ve Grup 2\'deki hastalar arasında yaş, parite sayısı ve geçirilmiş pelvik cerrahi öyküsü oranı açısından istatistiksel olarak anlamlı farklılık tespit edilmedi (p=0,813; p=0,706 ve p=0,410). Grup 1 ve Grup 2\'deki hastalar arasında operasyon süresi (dk.), delta hb (gr/dl),hospitalizasyon süresi (gün) ve komplikasyon oranı açısından istatistiksel olarak anlamlı farklılık tespit edilmedi (p=0,197; p=0,085; p=0,086 ve p=0,353). Sonuçlar: Laparoskopik histerektomi günümüzde düşük komplikasyon oranları ve yüksek hasta memnuniyeti olan bir operasyon yöntemi olsa da artan cerrahi tecrübenin her zaman iyi peroperatif sonuçları garanti etmediği akılda tutulmalıdır.

Anahtar Kelimeler

Cerrahi tecrübe, histerektomi, laparoskopik

Kaynakça

• İsaoğlu Ü,Yılmaz M, Delibaş İB, et al. Histerektomi materyallerinde histopatolojik tanıların incelenmesi. Abant Medical Journal 2013;2:91-94.
• Nieboer TE, Johnson N, Lethaby A, et al. Surgical ap- proach to hysterectomy for benign gynaecological dis- ease. The Cochrane Database of Systematic Reviews 3:CD003677, 2009.
• Kluivers KB, Opmeer BC, Geomini PM, et al. Women’s preference for laparoscopic or abdominal hysterec- tomy. Gynecol Surg 6;223-228:2009.
• AAGL Advancing Minimally Invasive Gynecology Worldwide. AAGL position statement: route of hyster- ectomy to treat benign uterine disease. J Minim Inva- sive Gynecol 2011;18:1.
• Cengiz H, Dağdeviren H, Ekin M, et al. Surgical man- agement of tuboovarian abscess: Results of retro- spective case series. J Clin Exp Invest 2012;3:463- 466.
• Erkal N, İsenlik BS, Çağlar M, et al. Management of adnexal torsion. J Clin Exp Invest 2014;5:7-11.
• Englund M, Robson S. Why has the acceptance of laparoscopic hysterectomy been slow? Results of an anonymous survey of Australian gynecologists. J Minim Invasive Gynecol 2007;14:724-728.
• Brummer TH, Jalkanen J, Fraser J, et al. FINHYST, a prospective study of 5279 hysterectomies: complica- tions and their risk factors. Hum Reprod 2011;26:1741- 1751.
• Twijnstra AR, Blikkendaal MD, van Zwet EW, et al. Pre- dictors of successful surgical outcome in laparoscopic hysterectomy. Obstet Gynecol 2012;119:700-708.
• O’Hanlan KA, Dibble SL, Garnier AC, Reuland ML. Total laparoscopic hysterectomy: technique and com- plications of 830 cases. JSLS 2007;11:45-53.
• Chopin N, Malaret JM, Lafay-Pillet MC, et al. Total laparoscopic hysterectomy for benign uterine patholo- gies: obesity does not increase the risk of complica- tions. Hum Reprod 2009;24:3057-3062.
• Malinowski A, Makowska J, Antosiak B. Total laparo- scopic hysterectomy--indications and complications of 158 patients. Ginekol Pol 2013;84:252-257.
• Mäkinen J, Johansson J, Tomás C, et al. Morbidity of 10 110 hysterectomies by type of approach. Hum Reprod 2001;16:1473-1478.
• Petros PP. The intravaginal slingplasty operation, a minimally invasive technique for cure of urinary in- continence in the female. Aust N Z J Obstet Gynaecol 1996;36:453-461.
• Yavuzcan A, Çağlar M ,Üstün Y,et al. The Effects of Age, Parity, Menopause and Previous Pelvic Surgery on the Outcomes of Laparoscopic Hysterectomy. Düzce Tıp Dergisi 2013 (basımda).
• Ayala-Yáñez R, Briones-Landa C, Anaya-Coeto H, et al.Total laparoscopic hysterectomy: descriptive study of institutional experience with 198 cases. Ginecol Obstet Mex 2010;78:605-611.