Complications after benign hysterectomy, according to procedure:a population-based prospective cohort study from the Danish hysterectomy database, 2004–2015

Autor: Margit Dueholm, Tine Iskov Kopp, Helga Gimbel, Pia Arnum Froeslev, Annemette Joergensen, Annette Settnes, Christina Norrbom, Steen Rasmussen, Charlotte Moeller, Märta Fink Topsoee, Eva Dreisler, Bent Ottesen
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Postoperative Complications/epidemiology
medicine.medical_specialty
Complications
VAGINAL HYSTERECTOMY
medicine.medical_treatment
Hysterectomy
Vaginal/adverse effects
Population
computer.software_genre
SURGICAL COMPLICATIONS
CLASSIFICATION
laparoscopic
03 medical and health sciences
0302 clinical medicine
Epidemiology
ROUTES
medicine
Humans
RATES
Prospective Studies
Registries
surgical morbidity
hysterectomy
Prospective cohort study
education
education.field_of_study
030219 obstetrics & reproductive medicine
Hysterectomy
Intention-to-treat analysis
LAPAROSCOPIC HYSTERECTOMY
Database
business.industry
Obstetrics and Gynecology
Uterine prolapse
Hysterectomy/adverse effects
Middle Aged
medicine.disease
Comorbidity
Denmark/epidemiology
Laparoscopy/adverse effects
Length of Stay/statistics & numerical data
Relative risk
minimally invasive
Female
epidemiology
business
computer
Zdroj: Settnes, A, Moeller, C, Topsoee, M F, Norrbom, C, Kopp, T I, Dreisler, E, Joergensen, A, Dueholm, M, Rasmussen, S C, Froeslev, P A, Ottesen, B & Gimbel, H 2020, ' Complications after benign hysterectomy, according to procedure : a population-based prospective cohort study from the Danish hysterectomy database, 2004–2015 ', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 127, no. 10, pp. 1269-1279 . https://doi.org/10.1111/1471-0528.16200
Settnes, A, Moeller, C, Topsoee, M F, Norrbom, C, Kopp, T I, Dreisler, E, Joergensen, A, Dueholm, M, Rasmussen, S C, Froeslev, P A, Ottesen, B & Gimbel, H 2020, ' Complications after benign hysterectomy, according to procedure : a population-based prospective cohort study from the Danish hysterectomy database, 2004-2015 ', B J O G, vol. 127, no. 10, pp. 1269-1279 . https://doi.org/10.1111/1471-0528.16200
Settnes, A, Moeller, C, Topsoee, M F, Norrbom, C, Kopp, T I, Dreisler, E, Joergensen, A, Dueholm, M, Rasmussen, S C, Froeslev, P A, Ottesen, B & Gimbel, H 2020, ' Complications after benign hysterectomy, according to procedure : a population-based prospective cohort study from the Danish hysterectomy database, 2004–2015 ', B J O G, vol. 127, no. 10, pp. 1269-1279 . https://doi.org/10.1111/1471-0528.16200
DOI: 10.1111/1471-0528.16200
Popis: OBJECTIVE: To compare the risk of complications associated with benign hysterectomy according to surgical procedure.DESIGN: Register-based prospective cohort study.SETTING: Danish Hysterectomy Database, 2004-2015.POPULATION: All Danish women with benign elective hysterectomy (n = 51 141).METHODS: Multivariate log-binomial regression to compute relative risks (RRs) stratified by calendar period, and adjusted for age, height, weight, smoking habits, use of alcohol, comorbidity, indications, uterine weight and adhesions. Multiple imputation and 'intention to treat' analyses were performed.MAIN OUTCOME MEASURES: Major (grades III-V) and minor (grades I-II) Clavien-Dindo modified complications within 30 days.RESULTS: Overall, major complications occurred in 3577 (7.0%) hysterectomies and minor complications occurred in 4788 (9.4%). The proportions of major and minor complications according to type of hysterectomy were: 10.3 and 9.6% for abdominal hysterectomy (AH); 4.1 and 12.1% for laparoscopic hysterectomy (LH); and 4.9 and 8.0% for vaginal hysterectomy (VH) for non-prolapse, and 2.3 and 6.4% for prolapse. In multivariate analyses, compared with VH for non-prolapse, the risk of major complications was higher for AH (RR 1.82, 95% CI 1.63-2.03) but lower for both LH (RR 0.78, 95% CI 0.68-0.90) and VH for prolapse (RR 0.55; 95% CI 0.41-0.75). For LH, the risk of major complications reduced from a RR of 0.96 (95% CI 0.75-1.22) in the time period 2004-2009 to an RR of 0.72 (95% CI 0.60-0.87) between 2010 and 2015.CONCLUSION: Laparoscopic hysterectomy and VH for uterine prolapse are associated with fewer major complications, and AH is associated with more major complications, compared with VH performed in the absence of uterine prolapse.TWEETABLE ABSTRACT: Laparoscopic hysterectomy has fewer major complications compared with vaginal hysterectomy, in the absence of uterine prolapse.
Databáze: OpenAIRE
Externí odkaz: