Feasibility and safety of total laparoscopic hysterectomy for uteri weighing from 1.5 kg to 11.000 kg
| Autor: | Clelia Madeddu, Ivan Collu, Antonio Macciò, Fabrizio Lavra, Paraskevas Kotsonis, Elisabetta Sanna, Sonia Nemolato, Giacomo Chiappe |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Uterus Gynecologic oncology Hysterectomy 03 medical and health sciences 0302 clinical medicine Obstetrics and gynaecology Quality of life Laparotomy medicine Humans Minimally Invasive Surgical Procedures Laparoscopy 030219 obstetrics & reproductive medicine medicine.diagnostic_test Leiomyoma business.industry Obstetrics and Gynecology Postoperative complication General Medicine Organ Size Length of Stay Middle Aged Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Urogenital Abnormalities Quality of Life Feasibility Studies Female business |
| Zdroj: | Archives of gynecology and obstetrics. 303(1) |
| ISSN: | 1432-0711 |
| Popis: | To assess the feasibility and safety of total laparoscopic hysterectomy (TLH) for uteri ≥ 1.5 kg. We prospectively evaluated all elective TLHs (with or without adnexectomy) performed for fibromatous uteri between August 2009 and August 2019 in the Department of Obstetrics and Gynecology, Sirai Hospital, Carbonia, and the Department of Gynecologic Oncology, Businco Hospital, Azienda Ospedaliera Brotzu, Cagliari. Patients with large myomatous uteri (uterine weight ≥ 1.5 kg on pathology reports) were included in the analysis. We examined all procedures and collected data about intra- and post-operative short-term and long-term complications, intraoperative blood loss, operative time, hospital stay, and time to achieve well-being. Seventy-eight patients were included. The median weight was 2,000 g (range 1,500–11,000 g), estimated blood loss was 100 mL (range 10–700 mL), operating time was 135 min (range 60–300 min), and hospital stay was 2 days (range 2–5 days). Conversion to laparotomy occurred in 4 patients (5.1%) with uterine weight ranging from 3 to 5.5 kg, due to severe adherence syndrome or inadequate visualization. As for intraoperative complications, 1 patient (who had the largest removed uterus weighing 11,000 g) experienced an intraoperative ureteral injury (grade III). No major postoperative complications occurred. This study provides the largest case series of TLH for fibromatous uteri > 1.5 kg and includes some of the largest uteri reported to date in the literature (weighing 5,320, 5,720, and 11,000 g, respectively). The study reaffirms the feasibility and safety of a minimally invasive hysterectomy even in the case of abnormally large uteri. |
| Databáze: | OpenAIRE |
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