Prospective randomized comparison between an open and closed vaginal cuff in abdominal hysterectomy

Aharoni, Ariel; Kaner, E.; Levitan, Z.; Condrea, Alexander; Degani, S.; Ohel, Gonen

doi:10.1016/s0020-7292(98)00116-7

Cited by 12 publications

(17 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A brief review in the last six years in attention to surgical management of vaginal vault after total abdominal hysterectomy showed only reports in human being [5][6][7][8][9][10][11][12][13][14][15] . All of them stand up the relations of the surgical techniques of vault closure to post operative complains.…”

Section: Discussionmentioning

confidence: 99%

“…The total abdominal hysterectomy with vaginal vault closure is more frequently reported than the open vault technique 15,17 , probably due to longer operation time of open procedure. This longer operation time for the open vault technique stems from the need for both peritoneal cover and haemostatic sutures around the vaginal cuff.…”

Section: Discussionmentioning

confidence: 99%

“…In the closed vault procedure the pelvic fluid collection is probably the result of a mixture of blood, lymphatic and serous fluid and necrotic debris that collects around the vaginal vault 15,22 . The organic reaction to the material of suture and the ischemia promote by continue or interrupted suture should be responsible by the main rate of necrosis debris.…”

Section: Discussionmentioning

confidence: 99%

“…These symptoms were associated to problems involving the vaginal cuff including bleeding 9 , haematoma 7,11 , cellulitis 9,12 , abscess formation 9 , tissue granulation 9,13 , granuloma 9,13 or visceral adhesions to vaginal vault 14 . These complications occurrence could be associated to the technique (open or a closed vaginal cuff) or to the type of vaginal cuff suture 15 . Ideally, appropriate surgical management of the vaginal cuff should be technically simple, minimize risk of infection, dehiscence, and blood loss, and reduce frequency of delayed complications such as cuff tissue granulation 16 .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

et al. 2009

View full text Add to dashboard Cite

Purpose:To investigate the effectiveness of fibrin glue in comparison with polyglycolic acid suture to promote the closure of rabbit's vaginal vault, after abdominal hysterectomy. Methods: Twenty female, adults, New Zealand rabbits, were submitted to abdominal hysterectomy and randomly distributed to polyglycolic acid suture (G-PA / n=10) or fibrin glue closure of vaginal vault (G-FG / n=10). Radiograph study allowed identifying vault vaginal suture disrupter or fistulas to urinary bladder or rectum. Videovaginoscopy study allowed identifying the presence of cellulites, abscess formation, tissue granulation or granuloma. Vaginal cuff burst test allowed to identify by the escape of air bubbles and rupture pression record. Histological sections stained with Picrosirius red allowed the measure of fibrous tissue healing. Results: The videovaginoscopy identified a significant difference (Fisher Test p<0.3142) of granulation tissue in the animals of G-PA (40%) in comparison with the G-FG (20%). The gross inspection showed the same relation in the granulation tissue occurrence (Fisher test p< 0.1749) with G-PA (50%) and G-FB (20%). The visceral adhesion to the vaginal vault wound was statistical significant (Fisher test p< 0.1749) with G-PA (50%) and G-FG (20%). The pressure of rupture (mm Hg) of the burst test was similar (p<0.0421) in the animals of G-PA (61.5±19.3) and G-FG (72.5±21.9). The collagen matrix of vault wound healing was similar (p< 0.0231) between the G-PA (31.63±15) and the G-FG (23.2±13.2). Conclusion: The vaginal vault closure using the fibrin glue is a safe and reliable procedure after abdominal hysterectomy in female rabbit model.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

et al. 2009

View full text Add to dashboard Cite

show abstract

“…We identified four RCTs (n0612) published between 1992 and1998 [23][24][25][26]. Though they differed in how they closed the cuff and the primary outcomes, two of three RCTs noted a significant decrease in the operative time when the cuff was closed, possibly due to the hemostasis at the vaginal cuff obtained during closure with staples or sutures [23,26]. Using staples to close the cuff [23], there was significant improvement in intraoperative hemostasis and granulation at 6 weeks postoperative.…”

Section: Moderatementioning

confidence: 99%

Abdominal hysterectomy for benign indications: evidence-based guidance for surgical decisions

et al. 2012

View full text Add to dashboard Cite

The purpose of this review is to provide evidence-based guidance for surgical decisions during abdominal hysterectomy performed for benign indications. Using combinations of terms "abdominal," "hysterectomy," and "randomized clinical trials (RCT)," we performed Ovid, PubMed, and Cochrane searches for publications between 1988 and 2008. After reviewing over 3,000 abstracts, 19 RCT were identified. There are no grade A recommendations. The only grade B suggestion is use of a bipolar vessel sealing device (LigaSure) for vascular pedicles rather than sutures. Routine closure of peritoneum should be avoided. Evidence behind 71 % (15/21) of surgical steps is insufficient (grade I). Despite its common performance, there are no grade A recommendations that can be made for the technical aspects of abdominal hysterectomy. Since almost 70 % of the surgical steps during abdominal hysterectomy lack randomized clinical trials, adequately designed studies are needed to decrease perioperative morbidity.

show abstract

Small bowel evisceration after abdominal hysterectomy with open vaginal cuff technique: A case report

Dabiri,

Mehri,

Mollanorouzi

et al. 2024

Clinical Case Reports

View full text Add to dashboard Cite

Key Clinical MessageVaginal cuff dehiscence post‐hysterectomy is rare yet significant. Early recognition and prompt surgical intervention are crucial to prevent complications like bowel infarction. Consider second‐look laparotomy in cases of uncertain bowel viability.AbstractVaginal cuff dehiscence (VCD) is a rare but potentially life‐threatening complication following a hysterectomy characterized by the separation of the vaginal vault. This condition, which may result in vaginal evisceration (VE), presents a significant risk of pelvic contents, particularly the small bowel, protruding into the vagina. Early diagnosis and prompt surgical intervention are paramount to prevent severe complications, including bowel infarction, obstruction, and peritonitis. Although VCD and VE are rare, they require urgent surgical management to avoid adverse outcomes. We reported a case of small bowel evisceration in a woman with a history of total abdominal hysterectomy 6 months ago. VCD and VE are very rare but life‐threatening complications of hysterectomy. Discussing the symptoms with patients who have multiple risk factors is crucial to avoid severe sequels following hysterectomy. Based on our experience, performing a second‐look laparotomy is a reliable approach to ensure the viability of the intestinal loop. However, it will likely increase the risk of infection.

show abstract

Prospective randomized comparison between an open and closed vaginal cuff in abdominal hysterectomy

Cited by 12 publications

References 7 publications

Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

Abdominal hysterectomy for benign indications: evidence-based guidance for surgical decisions

Small bowel evisceration after abdominal hysterectomy with open vaginal cuff technique: A case report

Contact Info

Product

Resources

About