Deciding the Appropriate Route and Method of Hysterectomy for Women with Benign Diseases: A Cross-sectional Study at a Tertiary Care Hospital, India
Introduction: Different factors may influence the route of hysterectomy for benign indications. Each of the three main approaches of hysterectomy has its own set of risks and benefits. A rational and evidence-based decision to select a right method for a particular patient is necessary to bring...
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doaj-f8dbaa9d06954cafbe0f60baf5ed8e472021-06-19T06:18:17ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-06-01156QC09QC1210.7860/JCDR/2021/46693.15018Deciding the Appropriate Route and Method of Hysterectomy for Women with Benign Diseases: A Cross-sectional Study at a Tertiary Care Hospital, IndiaHiralal Konar0Madhutandra Sarkar1Dorothy Dessa2Professor, Department of Obstetrics and Gynecology, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India.Professor, Department of Obstetrics and Gynecology, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India.Resident, Department of Obstetrics and Gynecology, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India.Introduction: Different factors may influence the route of hysterectomy for benign indications. Each of the three main approaches of hysterectomy has its own set of risks and benefits. A rational and evidence-based decision to select a right method for a particular patient is necessary to bring about the best possible outcome with least complications. Aim: To compare three groups of hysterectomy, i.e., laparotomy for Total Abdominal Hysterectomy (TAH), Non-descent Vaginal Hysterectomy (NDVH) and Total Laparoscopic Hysterectomy (TLH), with regard to the patient and clinical factors, surgical outcomes and complications, in order to decide the optimum route and method of hysterectomy in a patient with benign disease. Materials and Methods: In this hospital-based crosssectional study, one hundred and twenty women, with 40 patients each in the TAH, NDVH and TLH groups, were admitted due to benign gynaecological conditions in a tertiary care hospital in Kolkata, India from May 2013 to April 2014. They were operated, and then followed up at 6 to 12 weeks after surgery. All the relevant information, e.g., clinical diagnosis, operating time, intraoperative blood loss, length of stay in hospital, postoperative pain score, intraoperative and postoperative complications, etc., was recorded. Data were analysed statistically by simple proportions and statistical tests, i.e., chi-square test and F-test. Results: The most common indication for hysterectomy was benign diseases in all the groups, 47.5%, 40% and 37.5% respectively in the TAH, NDVH and TLH groups. The mean operating time (minutes) was significantly higher in the TLH group (163.5) as compared to the TAH (75.03) and NDVH groups (84.88) (p=0.039). A significantly lesser mean intraoperative blood loss (ml) was observed in the NDVH (85.67) and TLH groups (98.63) as compared to the TAH group (168.47) (p=0.021). The observations in regard to other surgical outcome parameters, i.e., postoperative pain score, hospital stay, were also favourable in the NDVH or TLH group. The complication rate was higher in the TAH group (22/40 or 55%) as compared to the NDVH (14/40 or 35%) and TLH (17/40 or 42.5%) groups. Conclusion: NDVH or TLH is the preferred method over TAH in case of benign uterine disease due to lesser operative morbidity and faster recovery.https://www.jcdr.net/articles/PDF/15018/46693_CE[Ra]_F(Sh)_PF1[AKA-IK]_PFA2(AKA_KM)_PN(KM).pdfcomparativefibroidnondescent vaginal hysterectomyroutetotal abdominal hysterectomytotal laparoscopic hysterectomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hiralal Konar Madhutandra Sarkar Dorothy Dessa |
spellingShingle |
Hiralal Konar Madhutandra Sarkar Dorothy Dessa Deciding the Appropriate Route and Method of Hysterectomy for Women with Benign Diseases: A Cross-sectional Study at a Tertiary Care Hospital, India Journal of Clinical and Diagnostic Research comparative fibroid nondescent vaginal hysterectomy route total abdominal hysterectomy total laparoscopic hysterectomy |
author_facet |
Hiralal Konar Madhutandra Sarkar Dorothy Dessa |
author_sort |
Hiralal Konar |
title |
Deciding the Appropriate Route and Method of Hysterectomy for Women with Benign Diseases: A Cross-sectional Study at a Tertiary Care Hospital, India |
title_short |
Deciding the Appropriate Route and Method of Hysterectomy for Women with Benign Diseases: A Cross-sectional Study at a Tertiary Care Hospital, India |
title_full |
Deciding the Appropriate Route and Method of Hysterectomy for Women with Benign Diseases: A Cross-sectional Study at a Tertiary Care Hospital, India |
title_fullStr |
Deciding the Appropriate Route and Method of Hysterectomy for Women with Benign Diseases: A Cross-sectional Study at a Tertiary Care Hospital, India |
title_full_unstemmed |
Deciding the Appropriate Route and Method of Hysterectomy for Women with Benign Diseases: A Cross-sectional Study at a Tertiary Care Hospital, India |
title_sort |
deciding the appropriate route and method of hysterectomy for women with benign diseases: a cross-sectional study at a tertiary care hospital, india |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2021-06-01 |
description |
Introduction: Different factors may influence the route of
hysterectomy for benign indications. Each of the three main
approaches of hysterectomy has its own set of risks and
benefits. A rational and evidence-based decision to select a
right method for a particular patient is necessary to bring about
the best possible outcome with least complications.
Aim: To compare three groups of hysterectomy, i.e., laparotomy
for Total Abdominal Hysterectomy (TAH), Non-descent Vaginal
Hysterectomy (NDVH) and Total Laparoscopic Hysterectomy
(TLH), with regard to the patient and clinical factors, surgical
outcomes and complications, in order to decide the optimum
route and method of hysterectomy in a patient with benign
disease.
Materials and Methods: In this hospital-based crosssectional study, one hundred and twenty women, with
40 patients each in the TAH, NDVH and TLH groups, were
admitted due to benign gynaecological conditions in a
tertiary care hospital in Kolkata, India from May 2013 to April
2014. They were operated, and then followed up at 6 to 12
weeks after surgery. All the relevant information, e.g., clinical
diagnosis, operating time, intraoperative blood loss, length of
stay in hospital, postoperative pain score, intraoperative and
postoperative complications, etc., was recorded. Data were
analysed statistically by simple proportions and statistical
tests, i.e., chi-square test and F-test.
Results: The most common indication for hysterectomy
was benign diseases in all the groups, 47.5%, 40% and
37.5% respectively in the TAH, NDVH and TLH groups. The
mean operating time (minutes) was significantly higher in
the TLH group (163.5) as compared to the TAH (75.03) and
NDVH groups (84.88) (p=0.039). A significantly lesser mean
intraoperative blood loss (ml) was observed in the NDVH (85.67)
and TLH groups (98.63) as compared to the TAH group (168.47)
(p=0.021). The observations in regard to other surgical outcome
parameters, i.e., postoperative pain score, hospital stay, were
also favourable in the NDVH or TLH group. The complication
rate was higher in the TAH group (22/40 or 55%) as compared
to the NDVH (14/40 or 35%) and TLH (17/40 or 42.5%) groups.
Conclusion: NDVH or TLH is the preferred method over TAH in
case of benign uterine disease due to lesser operative morbidity
and faster recovery. |
topic |
comparative fibroid nondescent vaginal hysterectomy route total abdominal hysterectomy total laparoscopic hysterectomy |
url |
https://www.jcdr.net/articles/PDF/15018/46693_CE[Ra]_F(Sh)_PF1[AKA-IK]_PFA2(AKA_KM)_PN(KM).pdf |
work_keys_str_mv |
AT hiralalkonar decidingtheappropriaterouteandmethodofhysterectomyforwomenwithbenigndiseasesacrosssectionalstudyatatertiarycarehospitalindia AT madhutandrasarkar decidingtheappropriaterouteandmethodofhysterectomyforwomenwithbenigndiseasesacrosssectionalstudyatatertiarycarehospitalindia AT dorothydessa decidingtheappropriaterouteandmethodofhysterectomyforwomenwithbenigndiseasesacrosssectionalstudyatatertiarycarehospitalindia |
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