Complications of Hysterectomy

Clarke‐Pearson, Daniel L.; Geller, Elizabeth J.

doi:10.1097/aog.0b013e3182841594

Cited by 271 publications

(215 citation statements)

References 43 publications

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“…Mas os casos de sangramento uterino aumentado na perimenopausa devem ser investigados por biópsia de Pipelle, a fim de excluir doenças endometriais, antes de se realizar uma histerectomia "profilática" 13 . Por outro lado, nos casos de mulheres que não desejam mais filhos, ao se realizar a histerectomia devem ser pesadas complicações que aumentam a morbidade peri e pós operatória, como hemorragia, lesões de órgãos adjacentes (tratos gastrointestinal e gênito-urinário), eventos tromboembólicos e infecção 14 . Em nosso estudo, das 68 mulheres com mais de 55 anos, 10% não foram submetidas à histerectomia, provavelmente pelo alto risco cirúrgico.…”

Section: Discussionunclassified

Preservação da fertilidade e dos ovários em mulheres com tumores anexiais benignos

Souza¹,

Yoshida²,

Peres³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Avaliar a preservação da fertilidade e dos ovários em mulheres submetidas à cirurgia por tumor anexial benigno. MÉTODOS: Para este estudo observacional com coleta prospectiva foram incluídas 206 mulheres operadas no CAISM-Unicamp de fevereiro de 2010 a janeiro de 2014. A preservação da fertilidade foi definida como tumorectomia ou anexectomia unilateral sem histerectomia em mulheres na pré-menopausa. A preservação ovariana foi considerada quando pelo menos um ovário ou parte dele foi preservado. RESULTADOS: Das 206 mulheres com tumores anexiais benignos, 120 (58%) estavam na pré-menopausa e 86 (42%) na pós-menopausa. Na pré-menopausa, foram encontrados 36 (30%) tumores de células germinativas, 31 (26%) neoplasias epiteliais e 11 (9%) do cordão sexual e estroma. Na pós-menopausa foram identificados 35 (41%) neoplasias epiteliais, 27 (31%) do cordão sexual e estroma e 8 (9%) de células germinativas. Entre as 36 mulheres com tumores ovarianos não neoplásicos, 21 (58%) apresentavam endometriomas e 8 (22%) cistos funcionais. Das 22 mulheres com tumores extra ovarianos, o leiomioma uterino foi o achado mais frequente (50%). Entre as pacientes com ≤35 anos, 26 (57%) foram submetidas à tumorectomia e 18 (39%) a anexectomia unilateral com preservação do útero e anexo contralateral. Mulheres com ≤35 anos foram mais frequentemente operadas por laparoscopia que esteve associada a maior taxa de preservação de fertilidade quando comparada com a laparotomia (p<0,01). Observou-se que 26 das pacientes submetidas à histerectomia com anexectomia (28%) bilateral estavam na pré-menopausa. CONCLUSÕES: Embora se observe uma tendência em realizar apenas tumorectomia em mulheres com ≤35 anos, uma proporção significativa de mulheres jovens ainda é submetida à anexectomia. Em mulheres entre 36 e 45 anos, apenas dois terços tiveram sua fertilidade preservada e 20% tiveram ambos os ovários removidos. No entanto, deve-se tentar preservar os ovários sempre que possível, sobretudo nas mulheres na pré-menopausa. Abstract PURPOSE:To evaluate the sparing of fertility and ovaries in women submitted to surgical treatment for benign adnexal tumors. METHODS: Between February 2010 and January 2014, 206 patients were included in this observational study as they were submitted to surgical treatment for benign ovarian tumors at CAISM, a tertiary hospital. Fertility sparing surgery was defined as tumorectomy or unilateral salpingoophorectomy without hysterectomy in premenopausal women. Preservation of the ovary occurred when at least one ovary or part of it was mantained. RESULTS: Of the 206 women with benign tumors, 120 (58%) were premenopausal and 86 (42%) were postmenopausal. There were 36 (30%) ovarian germ cell tumors, 31 (26%) epithelial neoplasms and 11 (9%) sex-cord stromal tumors among premenopausal women. In the group of postmenopausal women, 35 (41%) epithelial neoplasms, 27 (31%) sex-cord stromal tumors and 8 (9%) ovarian germ cell tumors were identified. Among 36 women with non-neoplastic ovarian tumors, 21 (58%) had

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Section: Discussionunclassified

Preservação da fertilidade e dos ovários em mulheres com tumores anexiais benignos

Souza¹,

Yoshida²,

Peres³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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“…Complications between classical laparoscopic-assisted vaginal hysterectomy (LAVH) and modified laparoscopic-assisted vaginal hysterectomy low incidence in LAVH at 0.28% [23].…”

Section: Characteristicsmentioning

confidence: 99%

Feasibility of modified laparoscopic assisted vaginal hysterectomy for decreasing urinary tract complications

Choi¹,

Ji²

2017

Clin Obstet Gynecol Reprod Med

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Objective: To analyze the differences in the incidence of postoperative complications in the bladder and urinary system between patients who received modified laparoscopic-assisted vaginal hysterectomy (LAVH) and those who received classical LAVH to reduce bladder and urinary system complications. Method:Patients who underwent LAVH for uterine disease at Inje University Haeundae Paik Hospital between March 2010 and June 2015 were included in this retrospective study. The incidence of postoperative urinary complications was compared between patients who received modified LAVH and those who received classical LAVH group.Result: Among a total of 463 patients, there was no significant difference in the incidence of bladder complications between the classical LAVH group and modified LAVH group (9/234 vs. 4/229, P = 0.172). However, the incidence of intraoperative bladder injury was significantly different between the two groups (7/234 vs. 1/229, P = 0.035). Conclusion:The incidence of intraoperative bladder injuries was significantly reduced in the patients who received modified LAVH.

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“…13 Many studies on femoral nerve injury agree in that it is due to the side blades on retractors. 10,11,12,13 Abdominal Cutaneous Nerve Injury Some of Ehler's research focused on clinical manifestations of other post-surgery (via the abdomen or vagina) neurological iatrogenic effects and published that injury inflicted on the genitofemoral nerves produce pain in the crural and vulvar areas; injury to the lateral femoral cutaneous nerve causes paresthesia on the antelateral thigh; and injury to the obdurate nerve is due to the weakening of thigh muscles, with a decrease in strength of the foot and while walking. When the injury affects the pudendal nerve, functional anatomical changes include urinary and fecal incontinence as well as pain the perineum.…”

mentioning

confidence: 99%

Etiology of Infection, Femoral Nerve and Splenic Injury by Abdominal Retractor

Sánchez¹,

Cavazos²,

Salinas³

et al. 2014

Gynecol Obstet Res Open J

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The aim of this work is to identify the underlying factors of infections in surgical wounds, as well as injury to the femoral nerve and spleen. Medical literature dating between the years 2000 and 2013 was reviewed using PubMed's electronic service. The structure and shape of semi-automatic retractors used for abdominal surgical procedures were studied. The results we obtained showed that the etiology of infection in surgical wounds and injury to the femoral nerve and spleen are due to semi-automatic retractors. We conclude that prophylactic antibiotic therapy is not sufficient in eradicating these surgical wound infections or injury to the femoral nerve and spleen. This reorganization was based on the Institute of Medicine's (IOM) 2010 analysis of NCI clinical research. This report was highly critical of the inefficiency of the process by which the cooperative groups carry out their trials. Historically, relatively few U.S. oncologists have even participated in clinical research, mostly from academic institutions. Community oncologists, who see the great majority of American cancer patients, have generally been reluctant to participate in federal clinical research due to the bureaucratic burden and low reimbursement. As a result, more than half of the trials initiated by the NCI's cooperative groups do not meet their accrual goals and are closed, generating no data. Further, the attendant bureaucracy ensures that each new Phase III trial startup costs well over a million dollars, which becomes a total loss when a trial closes early. The IOM made a number of recommendations for improving and streamlining that process, including the consolidation of the groups.

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Complications of Hysterectomy

Cited by 271 publications

References 43 publications

Preservação da fertilidade e dos ovários em mulheres com tumores anexiais benignos

Preservação da fertilidade e dos ovários em mulheres com tumores anexiais benignos

Feasibility of modified laparoscopic assisted vaginal hysterectomy for decreasing urinary tract complications

Etiology of Infection, Femoral Nerve and Splenic Injury by Abdominal Retractor

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