[Hysterectomy for benign gynaecological disease: Surgical approach, vaginal suture method and morcellation: Guidelines].

Autor: Gauthier T; Département de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, avenue Larrey, 87000 Limoges, France. Electronic address: tristan.gauthier@chu-limoges.fr., Huet S; Département de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, avenue Larrey, 87000 Limoges, France., Marcelli M; Département de gynécologie-obstétrique, hôpital La-Conception, Aix-Marseille université, 147, boulevard Baille, 13005 Marseille, France., Lamblin G; Département de gynécologie-obstétrique, hôpital Femme-Mère-Enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon-Bron, France., Chêne G; Département de gynécologie-obstétrique, hôpital Femme-Mère-Enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon-Bron, France.
Jazyk: francouzština
Zdroj: Journal de gynecologie, obstetrique et biologie de la reproduction [J Gynecol Obstet Biol Reprod (Paris)] 2015 Dec; Vol. 44 (10), pp. 1168-82. Date of Electronic Publication: 2015 Oct 31.
DOI: 10.1016/j.jgyn.2015.09.032
Abstrakt: Objective: To provide clinical practice guidelines from the French college of obstetrics and gynaecology (CNGOF), based on the best evidence available, concerning the surgical approach, the vaginal suture method, the surgeon's experience and morcellation to avoid complications with hysterectomy for benign gynaecological disease.
Material and Methods: English and French review of literature about complications with hysterectomy for benign gynaecological disease, excluding cancer.
Results and Conclusion: For benign gynaecological disease, vaginal (VH) or laparoscopic (LH) hysterectomy are recommended (grade B). In case of big uterus, VH or LH are recommended (grade C). VH is not contraindicated in nulliparous (Grade C). VH is not contraindicated in case of previous caesarean (grade C). In obese women, VH and LH are recommended (grade C). It should be recommended to perform at least 30 hysterectomies during learning curve (grade C). Hysterectomy should be performed by surgeon doing at least 10 hysterectomies each year (grade C). No vaginal suture method is recommended (grade C). It is recommended to assess cancer risk before (histological sample and/or imagery) when morcellation is planned (expert opinion).
(Copyright © 2015 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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