Pandey Deeksha, Sehgal Kriti, Saxena Aashish, Hebbar Shripad, Nambiar Jayaram, Bhat Rajeshwari G
Department of OBGYN, KMC Manipal, Manipal University, 4/1 KMC Flats, KMC Campus, Manipal 576104, Karnataka, India.
KMC Manipal, Manipal University, India.
Int J Reprod Med. 2014;2014:279273. doi: 10.1155/2014/279273. Epub 2014 Jan 2.
Objective. Aim of this audit was to analyze indications, complications, and correlation of preoperative diagnosis with final histopathology report of all hysterectomies, performed in a premier teaching hospital. Methods. Present study involved all patients who underwent hysterectomy at a premier university hospital in Southern India, in one year (from 1 January, 2012, to 31 December, 2012). Results. Most common surgical approach was abdominal (74.7%), followed by vaginal (17.8%), and laparoscopic (6.6%) hysterectomy. Most common indication for hysterectomy was symptomatic fibroid uterus (39.9%), followed by uterovaginal prolapse (16.3%). Overall complication rate was 8.5%. Around 84% had the same pathology as suspected preoperatively. Only 6 (5 with preoperative diagnosis of abnormal uterine bleeding and one with high grade premalignant cervical lesion) had no significant pathology in their hysterectomy specimen. Conclusion. Hysterectomy is used commonly to improve the quality of life; however at times it is a lifesaving procedure. As any surgical procedure is associated with a risk of complications, the indication should be carefully evaluated. With the emergence of many conservative approaches to deal with benign gynecological conditions, it is prudent to discuss available options with the patient before taking a direct decision of surgically removing her uterus.
目的。本次审计的目的是分析一家一流教学医院进行的所有子宫切除术的手术指征、并发症以及术前诊断与最终组织病理学报告之间的相关性。方法。本研究纳入了印度南部一家一流大学医院在一年内（2012年1月1日至2012年12月31日）接受子宫切除术的所有患者。结果。最常见的手术方式是经腹子宫切除术（74.7%），其次是经阴道子宫切除术（17.8%）和腹腔镜子宫切除术（6.6%）。子宫切除术最常见的指征是有症状的子宫肌瘤（39.9%），其次是子宫阴道脱垂（16.3%）。总体并发症发生率为8.5%。约84%患者的病理结果与术前怀疑的一致。只有6例（5例术前诊断为异常子宫出血，1例为高级别宫颈上皮内瘤变）子宫切除标本中无明显病理改变。结论。子宫切除术常用于改善生活质量；然而，有时它是一种挽救生命的手术。由于任何手术都有并发症风险，应仔细评估手术指征。随着处理良性妇科疾病的许多保守方法的出现，在直接决定手术切除患者子宫之前，与患者讨论可用的选择是谨慎的做法。
