National Technicity on the Rise: Ten Year Minimally Invasive Hysterectomy Trends for Women with Benign Uterine Disease in Canada
| Autor: | Togas Tulandi, Sarah Maheux-Lacroix, Paul J. Yong, Deborah Robertson, Innie Chen, Catherine Allaire, John Thiel, P.Y. Laberge, Ranjeeta Mallick, Elizabeth A. Randle, Liane Belland, Krista Cassell, Krisztina Bajzak, Chandrew Rajakumar, Olga Bougie, Abdul Jamil Choudhry, Geoffrey W. Cundiff, Jamie Kroft, Nicholas Leyland |
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| Rok vydání: | 2019 |
| Předmět: |
Gynecology
medicine.medical_specialty education.field_of_study 030219 obstetrics & reproductive medicine Hysterectomy Uterine disease business.industry Pelvic pain medicine.medical_treatment education Population Endometriosis Obstetrics and Gynecology Retrospective cohort study medicine.disease 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine Health information medicine.symptom business Abdominal hysterectomy |
| Zdroj: | Journal of Minimally Invasive Gynecology. 26:S41-S42 |
| ISSN: | 1553-4650 |
| Popis: | Study Objective Hysterectomies are the most commonly performed gynecologic procedure and are associated with faster recovery and decreased complications when performed minimally invasively compared with abdominally. The objectives were to measure temporal trends in minimally invasive hysterectomy for Canada and each province/territory and to determine whether provincial/territorial differences exist. Design National population-based retrospective study using federal administrative data from the Canadian Institute for Health Information. Technicity index (proportion of vaginal and laparoscopic hysterectomies) was calculated. Cochrane-Armitage test was applied for temporal trends and 2-sided p-values Setting Canada Patients or Participants All patients undergoing hysterectomy for benign indications in Canada from FY2006/7 to FY2016/17 Interventions Hysterectomy Measurements and Main Results 369,740 hysterectomies were included (48.4% abdominal; 28.3% laparoscopic; 23.3% vaginal). Mean age was 48.5 years (SD 11.2 years), and indications for surgery were menstrual bleeding disorders (29.7%), fibroids (23.7%), pelvic organ prolapse(19.8%), other(17.4%), endometriosis(5.8%) and pelvic pain(3.6%). National technicity index (proportion of vaginal and laparoscopic hysterectomies) increased (40.5%⟶63.2%). Abdominal hysterectomy decreased (59.5%⟶36.8%); laparoscopic increased (10.8%⟶38.6%); while, vaginal decreased (29.7%⟶24.5%). (p Increasing technicity index was observed in all provinces, though with variable increase over time. (p Manitoba(36.9%⟶44.4%; RR1.50,95%CI[1.43-1.58]*), Nova Scotia(46.4%⟶48.5%; RR1.39[1.31-1.48]*), New Brunswick(43.7%⟶50.3%; RR1.34[1.26-1.44]*), Newfoundland(35.3%⟶55.2%; RR1.21[1.10-1.33]*), Ontario (39.4%⟶63.0%, RR1.00[reference])Quebec(42.0%⟶61.8%; RR1.03[0.99-1.07]), Prince Edward Island(54.9%⟶64.3%; RR0.96[0.81-1.15]), Alberta(34.0%⟶64.3%; RR0.96[0.92-1.01]), British Columbia(43.4%⟶72.1%; RR 0.75[0.71-0.79]*), Saskatchewan(47.7%⟶83.9%; RR0.44[0.39-0.49]*). Conclusion Minimally invasive hysterectomy for benign indication has increased significantly in Canada over the past decade. However, the increase reflects increasing use of laparoscopic hysterectomy with a declining use of vaginal hysterectomy. The variation between provinces represents a technicity gap that warrants further study and intervention. |
| Databáze: | OpenAIRE |
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