Hysterectomies in Finland in 1990–2012: comparison of outcomes between trainees and specialists

Jokinen, Ewa; Brummer, Tea; Jalkanen, Jyrki; Fraser, Jaana; Heikkinen, Anna Maria; Mäkinen, Juha; Sjöberg, Jari; Tomás, Eija; Mikkola, Tomi S.; Härkki, Päivi

doi:10.1111/aogs.12654

Cited by 24 publications

(15 citation statements)

References 28 publications

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“…5 However, when comparing procedures performed by trainees or specialists, the rate of major complications requiring reoperation remained the same. 11 The use of laser angiography during robotic hysterectomy to assess the perfusion of the vaginal cuff and guide intraoperative decisions has been assessed in a feasibility trial including 20 women recently with good results. 12 Vaginal atrophy, co-morbidities that influence the healing process, increased age, smoking, radiation treatment, hysterectomy due to malignancy and infection have also been reported as risk factors for VCD.…”

Section: Discussionmentioning

confidence: 99%

Vaginal cuff dehiscence after total laparoscopic hysterectomy a case report and brief review of the literature

Kalogeropoulos

Chronopoulou

Iliopoulos

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Vaginal cuff dehiscence (VCD) is a serious complication of total laparoscopic hysterectomy (TLH) or trachelectomy with high morbidity, as it can potentially lead to evisceration/bowel ischemia and sepsis. Authors present a case report of vaginal cuff dehiscence after laparoscopic trachelectomy. The patient reported post-coital onset of symptoms. She presented with acute abdomen and required urgent surgical intervention. In this case surgical management was dictated by the clinical manifestation. However, authors argue that conservative management is also an option for some of these patients and the decision regarding the management plan should be personalized according to the clinical presentation and the patient’s expectations. Emphasis should be given to avoid early onset of sexual activity during the immediate recovery period. Compared to women who underwent an abdominal or vaginal hysterectomy, those who had a laparoscopic procedure have less post-operative pain, shorter recovery period and often they are advised to return early to their normal habits and their work place. It is expected that this group of patients feel well enough to resume sexual activity soon after their procedure. Therefore, our counselling is of paramount importance as it should be highlighted that sexual intercourse is possibly the most common triggering event for VCD which a serious complication with severe morbidity is. The resumption should, therefore, follow medical consultation and be individualized according to co-morbidities which could affect healing, intraoperative findings and evaluation of the whole recovery progress.

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Section: Discussionmentioning

confidence: 99%

Vaginal cuff dehiscence after total laparoscopic hysterectomy a case report and brief review of the literature

Kalogeropoulos

Chronopoulou

Iliopoulos

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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“…Når nye operasjonsmetoder innføres ved et sykehus, er kvalitetskontroll av metoden viktig. I andre nordiske land finnes hysterektomiregistre hvor operasjonsmetoder og resultater fortløpende registreres (3,7,8). Norge har ikke et slikt landsdekkende register.…”

Section: Fortolkningunclassified

“…Tendensen til å velge mindre invasive operasjonsmetoder gjenfinnes også i andre studier (3,6,9,10). Generelt anbefales vaginal hysterektomi dersom dette er mulig (11)(12)(13).…”

Section: Materiale Og Metodeunclassified

Hysterektomi ved St. Olavs hospital 1989–2014

Denstad¹,

S²,

Østrem³

et al. 2017

Tidsskriftet

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“…The surgeon's experience has been found to be important in reducing severe complications, especially in laparoscopic and vaginal hysterectomies. 5 However, no difference in major complications requiring reoperation was found between trainees and specialists in a later study 18. Nevertheless, a recent study reported that in centers with high laparoscopic expertise, the incidence of vaginal dehiscence is significantly lower when the entire procedure is completed laparoscopically compared with vaginal suturing of the cuff after TLH 17.…”

mentioning

confidence: 94%

Vaginal cuff dehiscence is observed in a higher rate after total laparoscopic hysterectomy compared with other types of hysterectomy

Ala-Nissilä

Laurikainen

Mäkinen

et al. 2018

Acta Obstet Gynecol Scand

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Hysterectomies in Finland in 1990–2012: comparison of outcomes between trainees and specialists

Abstract: Laparoscopic hysterectomy is more common in Finland than in the other Nordic countries. Although trainees need more time to operate, there were no differences between the trainees and the specialists with regard to major complication rates.

Cited by 24 publications

References 28 publications

Vaginal cuff dehiscence after total laparoscopic hysterectomy a case report and brief review of the literature

Vaginal cuff dehiscence after total laparoscopic hysterectomy a case report and brief review of the literature

Hysterektomi ved St. Olavs hospital 1989–2014

Vaginal cuff dehiscence is observed in a higher rate after total laparoscopic hysterectomy compared with other types of hysterectomy

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