Sharma Chanderdeep, Sharma Manupriya, Raina Rashmi, Soni Anjali, Chander Bal, Verma Suresh
Department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India.
Department of Pathology, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India.
J Midlife Health. 2014 Apr;5(2):55-61. doi: 10.4103/0976-7800.133988.
The aim of the study was to generate baseline data for indications of gynecological surgeries, and to assess route of surgery and histopathology correlation in women undergoing major gynecological surgery in a rural tertiary level teaching hospital in India.
Surgical indications, route of surgery and histopathology findings were reviewed and analyzed retrospectively, in 922 patients (≥35 years age) who underwent gynecological surgery at Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India from January 1, 2011 to May 31, 2013.
Of 922 surgeries, 65 had malignancy (7%). Pelvic organ prolapse (POP) (32.3%) and leiomyoma uterus (29%) were two most common benign indications for hysterectomy. Ovarian tumors were present in 13% (25% of these were malignant). Postmenopausal bleeding (PMB) was seen in 5.5% (55% of these were malignant).
All except 10% surgeries were done in the absence of definite histopathology diagnosis that is dysfunctional uterine bleeding (n = 42 [45%]), chronic pelvic pain/severe dysmenorrhea (n = 34 [36%]) and recurrent PMB (n = 17 [19%]). Majority of surgeries had histopathological correlation except for six cases (0.6%) of malignancy, which were missed on initial work-up. Majority of the surgeries were done abdominally. In rural areas of developing countries poverty, lack of regular follow-up, resource constraints and lack of technical skills (with respect to laparoscopic/robotic surgeries) pose major challenge in providing quality health care.
本研究旨在生成妇科手术指征的基线数据，并评估印度一家农村三级教学医院接受大型妇科手术的女性的手术途径与组织病理学之间的相关性。
回顾性分析2011年1月1日至2013年5月31日期间在印度喜马偕尔邦康格拉的拉金德拉·普拉萨德政府医学院接受妇科手术的922例患者（年龄≥35岁）的手术指征、手术途径和组织病理学结果。
922例手术中，65例为恶性肿瘤（7%）。盆腔器官脱垂（POP）（32.3%）和平滑肌瘤子宫（29%）是子宫切除术最常见的两个良性指征。卵巢肿瘤占13%（其中25%为恶性）。绝经后出血（PMB）占5.5%（其中55%为恶性）。
除10%的手术外，所有手术均在缺乏明确组织病理学诊断的情况下进行，即功能性子宫出血（n = 42 [45%]）、慢性盆腔疼痛/严重痛经（n = 34 [36%]）和复发性PMB（n = 17 [19%]）。除6例（0.6%）恶性肿瘤在初次检查时漏诊外，大多数手术与组织病理学相关。大多数手术通过腹部进行。在发展中国家的农村地区，贫困、缺乏定期随访、资源限制以及缺乏技术技能（关于腹腔镜/机器人手术）对提供优质医疗保健构成重大挑战。
