Laparoscopic Hysterectomy: Impact of Uterine Size
Abstract Objective To analyze surgical results of women having Type VII laparoscopic hysterectomy to determine whether differences in outcomes exist on the basis of uterine size. Methods This is an analysis of data from 983 cases of type VII laparoscopic hysterectomy performed from September 1996 th...
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| Veröffentlicht in: | Journal of minimally invasive gynecology 2011, Vol.18 (1), p.85-91 |
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| creator | O’Hanlan, Katherine A., MD McCutcheon, Stacey Paris, BA McCutcheon, John G., MBA |
| description | Abstract Objective To analyze surgical results of women having Type VII laparoscopic hysterectomy to determine whether differences in outcomes exist on the basis of uterine size. Methods This is an analysis of data from 983 cases of type VII laparoscopic hysterectomy performed from September 1996 through August 2010. Demographic and surgical data were stratified by uterine weight (range 14–3,131 g) less than 250 g (n = 720) and 250 g or more (n = 263). Analyses were done by Pearson’s χ2 , Wilcoxon rank-sum, and Kruskal-Wallis tests with significance set at 2-sided (p |
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Methods This is an analysis of data from 983 cases of type VII laparoscopic hysterectomy performed from September 1996 through August 2010. Demographic and surgical data were stratified by uterine weight (range 14–3,131 g) less than 250 g (n = 720) and 250 g or more (n = 263). Analyses were done by Pearson’s χ2 , Wilcoxon rank-sum, and Kruskal-Wallis tests with significance set at 2-sided (p <.05). Outcomes examined include estimated blood loss, skin-to-skin operative time, complications (non-reoperative and reoperative), and duration of hospital stay. Estimated blood loss, skin-to-skin operative time, and length of hospital stay were further analyzed using backwards, stepwise, multivariable, linear regression to control for and identify independent predictors affecting these outcomes. Baseline demographic data were included in the multivariable model. Only covariates that were significant in both multivariable and univariable analyses are presented as statistically significant. Design A case-controlled, retrospective study (Canadian Task Force Classification II-2). Results Median operating time varied by uterine weight, with a shorter duration of surgery in patients with uteri less than 250 g at 97 minutes (range 29–330), and patients with uteri greater than 250 g at 135 minutes (range 45–345) (p <.001). Median estimated blood loss was also less in patients with uteri less than 250 g at 50 mL, (range 0–1400), than in patients with uteri weighing 250 g or more, at 150 mL, (range 0–2100) (p <.001). There was no significant difference by uterine weight in median duration of hospital stay of 1 day (range 0–13), total complication rate (7.0%), reoperative complications (3.7%), or non-reoperative complications (3.4%). Duration of surgery, volume of blood lost, and length of hospital stay all decreased with the surgeon’s increasing experience. Conclusions Laparoscopic hysterectomy is feasible and safe, resulting in a short hospital stay, minimal blood loss, minimal operating time, and few complications for patients regardless of uterine weight.</description><identifier>ISSN: 1553-4650</identifier><identifier>EISSN: 1553-4669</identifier><identifier>DOI: 10.1016/j.jmig.2010.09.016</identifier><identifier>PMID: 21195958</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Fibroids ; Humans ; Hysterectomy ; Laparoscopy ; Middle Aged ; Myoma ; Obstetrics and Gynecology ; Organ Size ; Surgery ; Uterus - pathology</subject><ispartof>Journal of minimally invasive gynecology, 2011, Vol.18 (1), p.85-91</ispartof><rights>AAGL</rights><rights>2011 AAGL</rights><rights>Copyright © 2011 AAGL. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-5a1b97b6230088554edb11c14c6816a1823921772265294991d4cfa063dbf4013</citedby><cites>FETCH-LOGICAL-c410t-5a1b97b6230088554edb11c14c6816a1823921772265294991d4cfa063dbf4013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jmig.2010.09.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21195958$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O’Hanlan, Katherine A., MD</creatorcontrib><creatorcontrib>McCutcheon, Stacey Paris, BA</creatorcontrib><creatorcontrib>McCutcheon, John G., MBA</creatorcontrib><title>Laparoscopic Hysterectomy: Impact of Uterine Size</title><title>Journal of minimally invasive gynecology</title><addtitle>J Minim Invasive Gynecol</addtitle><description>Abstract Objective To analyze surgical results of women having Type VII laparoscopic hysterectomy to determine whether differences in outcomes exist on the basis of uterine size. Methods This is an analysis of data from 983 cases of type VII laparoscopic hysterectomy performed from September 1996 through August 2010. Demographic and surgical data were stratified by uterine weight (range 14–3,131 g) less than 250 g (n = 720) and 250 g or more (n = 263). Analyses were done by Pearson’s χ2 , Wilcoxon rank-sum, and Kruskal-Wallis tests with significance set at 2-sided (p <.05). Outcomes examined include estimated blood loss, skin-to-skin operative time, complications (non-reoperative and reoperative), and duration of hospital stay. Estimated blood loss, skin-to-skin operative time, and length of hospital stay were further analyzed using backwards, stepwise, multivariable, linear regression to control for and identify independent predictors affecting these outcomes. Baseline demographic data were included in the multivariable model. Only covariates that were significant in both multivariable and univariable analyses are presented as statistically significant. Design A case-controlled, retrospective study (Canadian Task Force Classification II-2). Results Median operating time varied by uterine weight, with a shorter duration of surgery in patients with uteri less than 250 g at 97 minutes (range 29–330), and patients with uteri greater than 250 g at 135 minutes (range 45–345) (p <.001). Median estimated blood loss was also less in patients with uteri less than 250 g at 50 mL, (range 0–1400), than in patients with uteri weighing 250 g or more, at 150 mL, (range 0–2100) (p <.001). There was no significant difference by uterine weight in median duration of hospital stay of 1 day (range 0–13), total complication rate (7.0%), reoperative complications (3.7%), or non-reoperative complications (3.4%). Duration of surgery, volume of blood lost, and length of hospital stay all decreased with the surgeon’s increasing experience. Conclusions Laparoscopic hysterectomy is feasible and safe, resulting in a short hospital stay, minimal blood loss, minimal operating time, and few complications for patients regardless of uterine weight.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Fibroids</subject><subject>Humans</subject><subject>Hysterectomy</subject><subject>Laparoscopy</subject><subject>Middle Aged</subject><subject>Myoma</subject><subject>Obstetrics and Gynecology</subject><subject>Organ Size</subject><subject>Surgery</subject><subject>Uterus - pathology</subject><issn>1553-4650</issn><issn>1553-4669</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9P3DAQxS0EKhT6BTig3DjtdsaOvTGqKiHUskgrcQDOluNMkEP-ESdI20-Po1049MDJo6f3njy_YewcYYmA6me1rBr_vOQQBdDLKB2wE5RSLFKl9OHnLOGYfQ-hAhArAPWNHXNELbXMThhubG-HLriu9y5Zb8NIA7mxa7ZXyV3TWzcmXZk8RdW3lDz4f3TGjkpbB_qxf0_Z098_jzfrxeb-9u7merNwKcK4kBZzvcoVFwBZJmVKRY7oMHUqQ2Ux40JzXK04V5LrVGssUldaUKLIyxRQnLLLXW8_dK8ThdE0Pjiqa9tSNwWTcS4UaDE7-c7p4iJhoNL0g2_ssDUIZiZlKjOTMjMpA9pEKYYu9vVT3lDxGflAEw2_dgaKS755GkxwnlpHhZ8JmaLzX_f__i_uat96Z-sX2lKoumloIz6DJnAD5mG-1XwqBIg_0Kl4B6m9i-g</recordid><startdate>2011</startdate><enddate>2011</enddate><creator>O’Hanlan, Katherine A., MD</creator><creator>McCutcheon, Stacey Paris, BA</creator><creator>McCutcheon, John G., MBA</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2011</creationdate><title>Laparoscopic Hysterectomy: Impact of Uterine Size</title><author>O’Hanlan, Katherine A., MD ; McCutcheon, Stacey Paris, BA ; McCutcheon, John G., MBA</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-5a1b97b6230088554edb11c14c6816a1823921772265294991d4cfa063dbf4013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Fibroids</topic><topic>Humans</topic><topic>Hysterectomy</topic><topic>Laparoscopy</topic><topic>Middle Aged</topic><topic>Myoma</topic><topic>Obstetrics and Gynecology</topic><topic>Organ Size</topic><topic>Surgery</topic><topic>Uterus - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O’Hanlan, Katherine A., MD</creatorcontrib><creatorcontrib>McCutcheon, Stacey Paris, BA</creatorcontrib><creatorcontrib>McCutcheon, John G., MBA</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of minimally invasive gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O’Hanlan, Katherine A., MD</au><au>McCutcheon, Stacey Paris, BA</au><au>McCutcheon, John G., MBA</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic Hysterectomy: Impact of Uterine Size</atitle><jtitle>Journal of minimally invasive gynecology</jtitle><addtitle>J Minim Invasive Gynecol</addtitle><date>2011</date><risdate>2011</risdate><volume>18</volume><issue>1</issue><spage>85</spage><epage>91</epage><pages>85-91</pages><issn>1553-4650</issn><eissn>1553-4669</eissn><abstract>Abstract Objective To analyze surgical results of women having Type VII laparoscopic hysterectomy to determine whether differences in outcomes exist on the basis of uterine size. Methods This is an analysis of data from 983 cases of type VII laparoscopic hysterectomy performed from September 1996 through August 2010. Demographic and surgical data were stratified by uterine weight (range 14–3,131 g) less than 250 g (n = 720) and 250 g or more (n = 263). Analyses were done by Pearson’s χ2 , Wilcoxon rank-sum, and Kruskal-Wallis tests with significance set at 2-sided (p <.05). Outcomes examined include estimated blood loss, skin-to-skin operative time, complications (non-reoperative and reoperative), and duration of hospital stay. Estimated blood loss, skin-to-skin operative time, and length of hospital stay were further analyzed using backwards, stepwise, multivariable, linear regression to control for and identify independent predictors affecting these outcomes. Baseline demographic data were included in the multivariable model. Only covariates that were significant in both multivariable and univariable analyses are presented as statistically significant. Design A case-controlled, retrospective study (Canadian Task Force Classification II-2). Results Median operating time varied by uterine weight, with a shorter duration of surgery in patients with uteri less than 250 g at 97 minutes (range 29–330), and patients with uteri greater than 250 g at 135 minutes (range 45–345) (p <.001). Median estimated blood loss was also less in patients with uteri less than 250 g at 50 mL, (range 0–1400), than in patients with uteri weighing 250 g or more, at 150 mL, (range 0–2100) (p <.001). There was no significant difference by uterine weight in median duration of hospital stay of 1 day (range 0–13), total complication rate (7.0%), reoperative complications (3.7%), or non-reoperative complications (3.4%). Duration of surgery, volume of blood lost, and length of hospital stay all decreased with the surgeon’s increasing experience. Conclusions Laparoscopic hysterectomy is feasible and safe, resulting in a short hospital stay, minimal blood loss, minimal operating time, and few complications for patients regardless of uterine weight.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>21195958</pmid><doi>10.1016/j.jmig.2010.09.016</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Case-Control Studies Female Fibroids Humans Hysterectomy Laparoscopy Middle Aged Myoma Obstetrics and Gynecology Organ Size Surgery Uterus - pathology |
| title | Laparoscopic Hysterectomy: Impact of Uterine Size |
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