Cortés FR, López VEA, Hortiales LÓI, Ramírez RJL, González DÓA, Ramírez SLF

Language: Spanish
References: 12
Page: 327-331
PDF size: 216.43 Kb.

ABSTRACT

Background: The laparoscopic total hysterectomy is an increasingly applied alternative in the surgical management of uterine pathology.
Objective: To describe the results obtained in patients that underwent total laparoscopic hysterectomy for the management of benign uterine pathology.
Material and method: We performed a descriptive, longitudinal and retrospective study in which results on 151 patients who underwent total laparoscopic hysterectomy between October 2008 and July 2011 are reported.
Results: The average age of the population was 42.5 years (30-56 years); body mass index averaged 25.8 kg/m2 (18-37 kg/m2). The most common surgical indication was uterine fibroids in 121 cases (80.1%). Among the surgical outcomes, the average operative time was 140.3 minutes (70-275 minutes); average total bleeding, 131 mL (50-400 mL); 3 cases (1.98%) of bladder injury were reported. The immediate postoperative evolution was hospitalization of 1.4 days (1-7 days). Late postoperative complications were fistulas of the urinary tract in 7 cases (4.63%), and in 1 case (0.66%) infection of the vaginal vault. The average weight of surgical specimens was 210 g (50-650 g).
Conclusions: Total laparoscopic hysterectomy is an appropriate therapeutic option We believe that careful selection of patients is critical to providing the best results.

REFERENCES

1. Sutton C. Past, present and future of hysterectomy. J Minimally Invasive Gynecol 2010;17:421-435.

2. Reich H, De Caprio J, Mac Glynn F. Laparoscopic hysterectomy. J Gynecol Surg 1989;5:213.

3. Donnez O, Jadoul P, Squifflet J, Donnez J. A series of 3190 laparoscopic hysterectomies for benign disease from 1990 to 2006: evaluation of complications compared with vaginal and abdominal procedures. BJOG 2009;116:492-500.

4. Neiboer T, Johnson N, Lethaby A, Tavender E, Curr E, Garry R, et al. Surgical approach to hysterectomy for benign gynaecological disease (Review). Cochrane Database Syst Rev 2009;CD003677.

5. Murillo IJM, Pedraza GLA, Aguirre OX, López GPE. Histerectomía por laparoscopia : experiencia de 10 años en el Hospital Español de México. Ginecol Obstet Mex 2007;75:667-677.

6. Morgan OF, López ZMA, Elorriaga GE, Soto PM, Lelevier RH. Histerectomía total laparoscópica: complicaciones y evolución clínica en una serie de 87 casos. Ginecol Obstet Mex 2008;76:520-525.

7. Ayala-Yáñez R, Briones-Landa C, Anaya-Coeto H, Leroy- López L, Zavaleta-Salazar R. Histerectomía total laparoscópica: estudio descriptivo de la experiencia institucional con 198 casos. Ginecol Obstet Mex 2010;78:605-611.

8. Hoffman C, Kennedy J, Borschel L, Burchette R, Kidd A. Laparoscopic hysterectomy: The Kaiser Permanente San Diego Experience. J Minimally Invasive Gynecol 2005;12:67-69.

9. Cipullo L, De Paoli S, Fasolino L, Fasolino A. Laparoscopic total hysterectomy compared to total hysterectomy. JSLS 2009;13:370-375.

10. Bonilla D, Mains L, Rice J, Crawford B. Total laparoscopic hysterectomy: our 5-year experience (1998-2002). The Ochsner Journal 2010;10:8-12.

11. Janssen P, Brolmann H, Huirne J. Recommendations to prevent urinary tract injuries during laparoscopic hysterectomy: a systematic Delphi procedure among experts. J Minimally Invasive Gynecol 2011;18: 314-321.

12. Makinen J, Johansson J, Tomás C, Tomás E, et al. Morbidity of 10,110 hysterectomies by type of approach. Hum Reprod 2001;16:1473-1478.