Marcelli M, Gauthier T, Chêne G, Lamblin G, Agostini A
Département de gynécologie-obstétrique, Aix-Marseille université, hôpital La Conception, 13284 Marseille, France.
Département de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, avenue Larrey, 87000 Limoges, France.
J Gynecol Obstet Biol Reprod (Paris). 2015 Dec;44(10):1206-18. doi: 10.1016/j.jgyn.2015.09.015. Epub 2015 Oct 29.
The National College of French gynecologists and obstetricians (CNGOF) decided to issue recommendations for clinical practice concerning the prevention of complications due to hysterectomy for benign disease.
Review of the English and French literature until May 2015 about complications with hysterectomy for benign gynaecological disease, excluding cancer. The following topics are covered in this article: prevention of venous thromboembolism risk, preoperative treatment that reduce the frequency of laparotomic hysterectomy and real interest of subtotal hysterectomy.
For the prevention of venous thromboembolism risk we advise to follow the recommendations of the SFAR. In case of hysterectomy for benign indication for which a median laparotomy is envisaged, given the volume of the uterus, it is recommended to prescribe GnRH agonists and then reassess the surgical approach (grade B). We do not observe significative differences regarding the sexual quality of life for laparotomic subtotal hysterectomy versus laparotomic total hysterectomy (EL1). We do not observe significative differences regarding the sexual quality of life for laparoscopic subtotal hysterectomy versus laparoscopic total hysterectomy (EL1). Subtotal hysterectomy is not associated with a significant improvement in the sexual quality of life (EL1). Subtotal hysterectomy is not associated with a decreased prevalence of intraoperative Hemorrhagic or visceral complications (EL3) or to a reduction in transfusions (EL2). It is not recommended to perform subtotal hysterectomy to reduce the risk of complications per or postoperative (grade B).
