Incidence and patient characteristics of vaginal cuff dehiscence after different modes of hysterectomies.

摘要: Abstract Study objective The purposes of this study were to estimate and compare the incidence vaginal cuff dehiscence after different modes hysterectomies (abdominal, vaginal, laparoscopic-assisted laparoscopic) review characteristics complicated by dehiscences. Design Observational case series (Canadian Task Force classification II-3). Setting Large, urban, university teaching hospital. Patients All patients undergoing a total hysterectomy or repair at Magee-Womens Hospital (MWH) from January 2000 through March 2006 analyzed. Interventions Vaginal separation with reduction eviscerating organ when appropriate. Measurements main results From 2006, 7286 (7039 247 supracervical) performed MWH abdominal, laparoscopic approach. Ten these dehiscences repaired during time period. resulting overall cumulative was 0.14%. annual 0%, 0.09%, 0.70%, 0.31% respectively. There notable increase in 2005 thereafter. mode 4.93% among (TLH), 0.29% (TVH), 0.12% abdominal (TAH). relative risks complication TLH compared TVH TAH 21.0 53.2, Both statistically significant, 95% CIs 2.6 166.9 6.7 423.4, Among 10 repaired, 8 (80%) complications TLHs, 1 (10%) associated TAH, followed TVH. median age 39 years, between initial 11 weeks. Six presented both bowel evisceration. reported first postoperative intercourse as trigger event. Half report smoking cigarettes. received preoperative prophylactic antibiotics hysterectomy. Until October there have been no recurrent MWH. Conclusions Total may be an increased risk other We postulate that use thermal energy addition factors unique surgery responsible; however, prospective randomized trials are needed support hypothesis. When performing hysterectomies, supracervical approach should considered unless clear indication for is present.