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A Swedish population-based evaluation of benign hysterectomy, comparing minimally invasive and abdominal surgery

Billfeldt, Nina K.; Borgfeldt, Christer LU ; Lindkvist, Håkan; Stjerndahl, Jan Henrik and Ankardal, Maud (2018) In European Journal of Obstetrics Gynecology and Reproductive Biology 222. p.113-118
Abstract

Objective: The aim was to evaluate surgical routes for benign hysterectomy in a Swedish population, including abdominal and minimally invasive surgery. Study design: Prospectively collected data from the Swedish National GynOp Registry 2009–2015: 13 806 hysterectomy cases were included: abdominal (AH, n = 7485), vaginal (VH, n = 3767), conventional laparoscopic (LH, n = 1539) and robotically-assisted (RAH, n = 1015). Results: The VH group had the shortest operation time at 75 min, AH 97 min and RAH 104 min. LH was longest at 127 min (p < 0.005). The mean estimated blood loss was higher in the AH group (250 ml) compared to all minimally invasive surgery (MIS, 65–172 ml); p < 0.005). Conversion rates were 10% for LH, 4.8% for VH and... (More)

Objective: The aim was to evaluate surgical routes for benign hysterectomy in a Swedish population, including abdominal and minimally invasive surgery. Study design: Prospectively collected data from the Swedish National GynOp Registry 2009–2015: 13 806 hysterectomy cases were included: abdominal (AH, n = 7485), vaginal (VH, n = 3767), conventional laparoscopic (LH, n = 1539) and robotically-assisted (RAH, n = 1015). Results: The VH group had the shortest operation time at 75 min, AH 97 min and RAH 104 min. LH was longest at 127 min (p < 0.005). The mean estimated blood loss was higher in the AH group (250 ml) compared to all minimally invasive surgery (MIS, 65–172 ml); p < 0.005). Conversion rates were 10% for LH, 4.8% for VH and 1.6% for RAH (p < 0.005). Hospitalization and patient-reported time to normal activities of daily living (ADL) were longer for AH compared to MIS (p < 0.005). Time to return to work was eight days longer in the AH group (35 days) compared with the MIS groups (p < 0.005). Complications were fewest in the VH group at 5.4% compared with AH 7.6% and RAH 8.7% (both p < 0.001), but did not significantly differ from the LH group at 6.6%. Overall patient satisfaction was reported to be 86–94% one year after surgery. Conclusion: Women operated on for benign hysterectomy with minimally invasive methods in Sweden 2009–2015 had reduced length of hospitalization, as well as time to resuming normal ADL and return to work, compared to AH. Postoperative outcome measures were improved by minimally invasive methods and MIS should preferably be used.

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organization
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type
Contribution to journal
publication status
published
subject
keywords
Hysterectomy, Laparoscopy, Minimally invasive approach, Robotic, Surgical route
in
European Journal of Obstetrics Gynecology and Reproductive Biology
volume
222
pages
6 pages
publisher
Elsevier
external identifiers
  • scopus:85041384517
ISSN
0301-2115
DOI
10.1016/j.ejogrb.2018.01.019
language
English
LU publication?
yes
id
23c1e557-00ac-4013-80f9-f070b8ea57ee
date added to LUP
2018-02-22 10:51:01
date last changed
2018-10-03 10:53:15
@article{23c1e557-00ac-4013-80f9-f070b8ea57ee,
  abstract     = {<p>Objective: The aim was to evaluate surgical routes for benign hysterectomy in a Swedish population, including abdominal and minimally invasive surgery. Study design: Prospectively collected data from the Swedish National GynOp Registry 2009–2015: 13 806 hysterectomy cases were included: abdominal (AH, n = 7485), vaginal (VH, n = 3767), conventional laparoscopic (LH, n = 1539) and robotically-assisted (RAH, n = 1015). Results: The VH group had the shortest operation time at 75 min, AH 97 min and RAH 104 min. LH was longest at 127 min (p &lt; 0.005). The mean estimated blood loss was higher in the AH group (250 ml) compared to all minimally invasive surgery (MIS, 65–172 ml); p &lt; 0.005). Conversion rates were 10% for LH, 4.8% for VH and 1.6% for RAH (p &lt; 0.005). Hospitalization and patient-reported time to normal activities of daily living (ADL) were longer for AH compared to MIS (p &lt; 0.005). Time to return to work was eight days longer in the AH group (35 days) compared with the MIS groups (p &lt; 0.005). Complications were fewest in the VH group at 5.4% compared with AH 7.6% and RAH 8.7% (both p &lt; 0.001), but did not significantly differ from the LH group at 6.6%. Overall patient satisfaction was reported to be 86–94% one year after surgery. Conclusion: Women operated on for benign hysterectomy with minimally invasive methods in Sweden 2009–2015 had reduced length of hospitalization, as well as time to resuming normal ADL and return to work, compared to AH. Postoperative outcome measures were improved by minimally invasive methods and MIS should preferably be used.</p>},
  author       = {Billfeldt, Nina K. and Borgfeldt, Christer and Lindkvist, Håkan and Stjerndahl, Jan Henrik and Ankardal, Maud},
  issn         = {0301-2115},
  keyword      = {Hysterectomy,Laparoscopy,Minimally invasive approach,Robotic,Surgical route},
  language     = {eng},
  pages        = {113--118},
  publisher    = {Elsevier},
  series       = {European Journal of Obstetrics Gynecology and Reproductive Biology},
  title        = {A Swedish population-based evaluation of benign hysterectomy, comparing minimally invasive and abdominal surgery},
  url          = {http://dx.doi.org/10.1016/j.ejogrb.2018.01.019},
  volume       = {222},
  year         = {2018},
}