Jokinen Ewa, Brummer Tea, Jalkanen Jyrki, Fraser Jaana, Heikkinen Anna-Mari, Mäkinen Juha, Sjöberg Jari, Tomàs Eija, Mikkola Tomi S, Härkki Päivi
Department of Obstetrics and Gynecology, Hospital District of Helsinki and Uusimaa/Hyvinkää Hospital, Hyvinkää, Finland.
Department of Obstetrics and Gynecology, Østfold Central Hospital, Fredrikstad, Norway.
Acta Obstet Gynecol Scand. 2015 Jul;94(7):701-707. doi: 10.1111/aogs.12654. Epub 2015 May 7.
To assess trends for hysterectomy methods in the Nordic countries and to compare outcomes of hysterectomies in Finland done by trainees with those done by specialists.
Register-based study.
NOMESCO database for the Nordic countries and the Finnish Hospital Discharge Register.
National prospective cohort of 5279 hysterectomies in Finland.
Numbers of hysterectomies in the Nordic countries were collected in 1995-2011 and in Finland in 1990-2012. The Finhyst study to collect data on hysterectomies for benign indications was carried out in Finland in 2006. Information concerning patients, surgeons, and hysterectomy outcome was analysed.
Hysterectomy numbers and methods. Operating time, blood loss, and complications in hysterectomies done by trainees and specialists.
In Finland, the rate of hysterectomies has been reduced by approximately 50% since the 1990s and is now similar to that in the other Nordic countries. The laparoscopic method is twice as common in Finland as in other Nordic countries, constituting 35-40% of all hysterectomies. The operating time for all hysterectomy methods was 16-25% longer among trainees than specialists. For the abdominal or laparoscopic methods there were no significant differences in the complication rates between the groups. In the vaginal approach, blood loss of ≥1000 mL was slightly more common in operations done by trainees (1.3% vs. 2.6%, p = 0.037).
Laparoscopic hysterectomy is more common in Finland than in the other Nordic countries. Although trainees need more time to operate, there were no differences between the trainees and the specialists with regard to major complication rates.
评估北欧国家子宫切除术方法的趋势，并比较芬兰实习医生与专科医生所做子宫切除术的结果。
基于登记的研究。
北欧国家的NOMESCO数据库和芬兰医院出院登记处。
芬兰5279例子宫切除术的全国前瞻性队列。
收集1995 - 2011年北欧国家以及1990 - 2012年芬兰的子宫切除术数量。2006年在芬兰开展了Finhyst研究，以收集良性指征子宫切除术的数据。分析了有关患者、外科医生和子宫切除术结果的信息。
子宫切除术数量和方法。实习医生和专科医生所做子宫切除术中的手术时间、失血量和并发症。
在芬兰，自20世纪90年代以来子宫切除术的发生率已降低了约50%，目前与其他北欧国家相似。腹腔镜手术方法在芬兰的应用频率是其他北欧国家的两倍，占所有子宫切除术的35 - 40%。所有子宫切除术方法中，实习医生的手术时间比专科医生长16 - 25%。对于腹部或腹腔镜手术方法，两组之间的并发症发生率无显著差异。在经阴道手术中，实习医生所做的手术中失血量≥1000 mL的情况略为常见（1.3%对2.6%，p = 0.037）。
腹腔镜子宫切除术在芬兰比其他北欧国家更常见。尽管实习医生手术所需时间更长，但在主要并发症发生率方面，实习医生与专科医生之间并无差异。
