A randomized study of total abdominal, vaginal and laparoscopic hysterectomy
| Autor: | J.A. Pinotti, Sérgio Conti Ribeiro, Ricardo Muniz Ribeiro, N.C. Santos |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors medicine.medical_treatment Population Blood Loss Surgical Endometriosis Hysterectomy Vesicovaginal fistula Hemoglobins Uterine cancer medicine Humans Prospective Studies Hysterosalpingography Laparoscopy education Aged Gynecology education.field_of_study Leiomyoma medicine.diagnostic_test Interleukin-6 business.industry Obstetrics and Gynecology General Medicine Middle Aged medicine.disease Surgery C-Reactive Protein Treatment Outcome Hysteroscopy Uterine Neoplasms Erythrocyte Count Female business Biomarkers |
| Zdroj: | International Journal of Gynecology & Obstetrics. 83:37-43 |
| ISSN: | 0020-7292 |
| DOI: | 10.1016/s0020-7292(03)00271-6 |
| Popis: | Objectives: To evaluate operative time, blood loss and inflammatory response in patients submitted to hysterectomy. Methods: Sixty patients referred for hysterectomy were prospectively randomized to total abdominal hysterectomy (n=20), vaginal hysterectomy (n=20), or laparoscopic hysterectomy (n=20). The operative time, blood loss (variation in erythrocyte and hemoglobin) and inflammatory answer (CRP and interleukin-6 dosages) were compared by using Kruskal–Wallis, Dunn non-parametric test and variance analysis with repeated measurements. Results: Operative time was shorter for vaginal hysterectomy, and there was no significant difference between total abdominal hysterectomy and laparoscopic hysterectomy. Reduction in erythrocyte and hemoglobin was more noticeable after vaginal hysterectomy, followed by total abdominal hysterectomy and laparoscopic hysterectomy. CRP levels increased steadily from vaginal hysterectomy to laparoscopic hysterectomy and then to total abdominal hysterectomy. The increase in interleukin-6 was substantially higher in total abdominal hysterectomy, whereas no difference was noted between vaginal and laparoscopic hysterectomy. Conclusions: Vaginal hysterectomy presents superior results in terms of operative time and inflammatory response when compared with total abdominal and laparoscopic hysterectomy and it should be the first option for hysterectomy. Laparoscopic hysterectomy should be considered when the vaginal approach is unfeasible, showing clear advantages over abdominal hysterectomy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text