2011, Number 2
<< Back Next >>
Revista Cubana de Cirugía 2011; 50 (2)
Vaginal hysterectomy in patients with uterus prolapse
García RME, Romero SRE
Language: Spanish
References: 26
Page: 155-163
PDF size: 132.61 Kb.
ABSTRACT
INTRODUCTION. In the medical literature is quoted the nulliparity, the existence
of previous operations and the uterus size as exclusion factors to choice the
hysterectomy technique. The aim of present research was to determine the
effectiveness and feasibility of vaginal hysterectomy by Heaney's technique, carried
out in patients without uterus prolapse even in presence of the above mentioned
factors.
METHODS. A multivariate, descriptive and observational study was conducted in a
sample including 1 000 patients operated on in the General Surgery service of the
"Martín Chang Puga" University Hospital in Nuevitas municipality (Camagüey
province, between May, 1994 and December, 2006. A database was designed in
Excel transferred to SPSS professional statistical package to carry out univaried,
bivaried and multivariate analyses, which finally were represented in frequency and
percentages tables. A significance of p= 0.05 was used.
RESULTS. The 6 % of patients were nulliparous and the 23,5 % had previous
surgeries of pelvis. A 82,6 % of patients had uteri with no more than an
approximate value of 12 weeks of pregnancy and the uterine fibroma was the
leading cause (88,5 %) of intervention. Only a 4,1 % of patients need blood
transfusion. The perioperative and postoperative complications accounted for the
1,7 % and the 19,3 %, respectively. The 97,2 % of patients stayed less than 48
hours in the hospital and the 99,4 % go back to normal life.
CONCLUSIONS. The nulliparity, the uterus size and the previous operations were
not considered like isolated and excluding factors for the vaginal route. However,
the type of hysterectomy will depends of the decision of the attending physician
and the patient, according the costs and benefits involved in each case.
REFERENCES
Abbott JA, Garry R. The surgical management of menorrhagia. Hum Reprod. 2002;8(1):68-78.
Reyes Fuentes S, García Andrade J, Elling Dirk FF. Histerectomía vaginal en úteros sin prolapso (Una técnica). Análisis retrospectivo de 50 pacientes. Rev Cubana Obstet Ginec. 1980;6(4):319-23.
Elling D, Reyes Fuentes S, Valdés Vivo P. Sobre la indicación y diagnóstico preoperatorio de la histerectomía total por vía vaginal. Rev Cubana Obstet Ginec. 1980;6(1):19-23.
Costa AAR. Comparação dos resultados intra e pós-operatórios da histerectomía vaginal versus histerectomía abdominal em mulheres sem prolapso uterino, em um hospital-escola do Recife: ensaio clínico randomizado. (Dissertação Mestrado Instituto Materno-Infantil de Pernambuco). Brasil; 2003.
Garry R. The eVALuate study: two parallel randomized trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ. 2004;328(7432):129.
Maresh MJA, Metcalfe MA, McPherson K. The VALUE National Hysterectomy Study: description of the patients and their surgery. Br J Obstet Gynecol. 2002;109:302-12.
Rodríguez N. La histerectomía vaginal en pacientes sin prolapso: indicaciones, técnica y recomendaciones. Rev Cubana Obstet Ginecol. 1995;21(1):23-5.
Reich H. Laparoscopic hysterectomy. Surgical Laparoscopy & Endoscopy. New York: Raven Press; 1992. Pp. 85-8.
Yovarone R. La histerectomía vaginal en úteros no prolapsados: Una vieja "nueva" opción. Arch Gin Obstet. 2002;40(1):223-6.
Mendoza Romero J, Alonso FJ, Dicriscio R, Pérez Canto G, Teppa Garran A. Histerectomía vaginal asistida por laparoscopia. Rev Obstet Ginecol Venez. 2005;65(2):69-75.
Fenner DE. Training of a gynecologic surgeon. Obstet Gynecol. 2005;105:193-6.
ACOG. Quality Assurance in Obstetrics and Gynaecology. Washington, DC: American College of Obstetricians and Gynaecologists; 2003.
Boukerrou M, Lambaudie E, Collinet P. A history of cesareans is a risk factor in vaginal hysterectomies. Acta Obstet Gynecol Scand. 2003;82:1135-9.
Van Den Eeden SK, Glasser M, Mathias SD. Quality of life, health care utilization, and costs among women undergoing hysterectomy in a managed-care setting. Am J Obstet Gynecol. 2005; 178:91-100.
Deval B, Rafii A, Soriano D. Morbidity of vaginal hysterectomy for benign tumours as a function of uterine weight. J Reprod Med. 2003;48:435-40.
Benassi L, Rossi T, Kaihura CT. Abdominal or vaginal hysterectomy for enlarged uteri: a randomized clinical trial. Am J Obstet Gynecol. 2002;187:1561-5.
Darai E, Soriano D, Kimata P, Laplace C, Lecuru F. Vaginal hysterectomy for enlarged uteri, with or without laparoscopic assistance randomized study. Obstet Gynecol. 2001;97:712-6.
Reich H, Roberto L. Laparoscopic hysterectomy in current gynaecological practice. Reviews in Gynaecological Practice. 2003;3:32-40.
Guarnaccia MM, Rein MS. Traditional surgical approaches to uterine fibroids: abdominal myomectomy and hysterectomy. Clin Obstet Gynecol. 2001;44(2):385-400.
Johnson N, Barlow D, Lethaby A, Tavender E, Curr L, Garrry R. Methods of hysterectomy: systematic review and metaanalysis of randomized controlled trial BMJ. 2005;330:1478.
Härkki-Sirén P, Sjöberg J, Tiitine F. Urinary tract injuries after hysterectomy. Obstet Gynecol. 1998;92:113-8.
Millán Rojas ÁL, Serrao AT. Histerectomía vaginal en ausencia de histerocele. RFM. 2007;30(1):18-23.
Comité de acreditación en transfusión (CAT). Estándares de acreditación. Asociación Española de Hematología y Hemoterapia. Sociedad Española de Transfusión Sanguínea Ind Gráf. 3eraEdición. Madrid: El Instalador; 2006. Pp. 44-50.
Paredes Vila P. Fístulas urinarias yatrogénicas en la mujer. Rev Cubana Cir. 1973;12(1):75-81.
Alonso Domínguez FJ. Complicaciones urológicas de la cirugía ginecológica. Rev Cubana Cir. 1986;34(4):4.
Salinas H. Análisis clínico y económico de la histerectomía abdominal versus la histerectomía vaginal en el hospital clínico de la universidad de chile. Revisión de 2.338 casos. Rev Chil Obstet Ginecol. 2006;71(4):227-33.