Conventional and laparoscopic-assisted vaginal hysterectomy in patients without uterine prolapse
Abstract
Background: hysterectomy is the most widely performed gynecological surgical procedure worldwide. Currently, there is no consensus on when to use one or the other approach, which is a problem to solve.
Objective: to compare the results of the application of laparoscopic-assisted vaginal and vaginal hysterectomy in patients with benign conditions of the uterus without uterine prolapse.
Methods: a descriptive, cross-sectional and retrospective study was carried out at the Manuel Ascunce Domenech University Hospital in the period from January 2017 to September 2019. The universe consisted of all patients with benign diseases of the uterus excluding prolapse, who underwent surgery with conventional vaginal hysterectomy and laparoscopic assisted techniques in the study period. The medical records and a prepared spreadsheet were used as a source to empty the data. The dependent variable was the results; it was classified as satisfactory or unsatisfactory. Independents variables were: age, surgical method, surgical indication, parity, previous abdominal surgeries, surgical time, intraoperative blood loss, surgical complications, and hospital stay.
Results: the conventional vaginal hysterectomy technique predominated over the one assisted by laparoscopy. There were not unsatisfactory results in no one of the two groups. The age group that prevailed in the patients was that of 40 to 49 years. Most of the patients were multiparous and had no history of previous abdominal surgeries. Conventional vaginal hysterectomy showed less surgical time and blood losses were less than 250 ml, with both techniques. The most frequent complications were related to vaginal cupules, as well as the prevailing hospital stay was less than 24 hours.
Conclusions: conventional vaginal hysterectomy, as well as laparoscopic-assisted hysterectomy, are the surgical techniques of choice for patients with benign uterine diseases other than prolapse, in those institutions where there are trained personnel and the necessary equipment to carry them out.
DeCS: HYSTERECTOMY, VAGINAL; SURGICAL PROCEDURES, OPERATIVE; LAPAROSCOPY; UTERINE CERVICAL DISEASES; POSTOPERATIVE COMPLICATIONS.
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