Topsoee Märta Fink, Ibfelt Else Helene, Settnes Annette
Department of Obstetrics and Gynecology, North Zealand Hospital, University of Copenhagen.
Registry Support Centre (East) - Epidemiology and Biostatistics, Research Centre for Prevention and Health, Glostrup University Hospital, Nordre Ringvej, Glostrup, Denmark.
Clin Epidemiol. 2016 Oct 25;8:515-520. doi: 10.2147/CLEP.S99465. eCollection 2016.
The steering committee of the Danish Hysterectomy and Hysteroscopy Database (DHHD) has defined the objective of the database: the aim is firstly to reduce complications, readmissions, reoperations; secondly to specify the need for hospitalization after hysterectomy; thirdly to secure quality assessment of hysterectomy and hysteroscopy by setting standards and national guidelines; and finally to intensify the monitoring of laparoscopic surgery and explore long-term side effects after hysterectomy.
We include all women in Denmark who have had elective benign uterine surgery since 2003. The surgery includes hysterectomy and operative hysteroscopy. In the latter, we include resection of the endometrium and submucosal leiomyomas and ablations of the endometrium.
Detailed information about the hysterectomy and hysteroscopy operation techniques, cooperations, and indications is registered directly in the National Patient Register (NPR), as well as relevant lifestyle factors and confounders. It is mandatory to register information about complications and readmissions in the NPR. Data included in DHHD are directly extracted from the NPR.
Annually approximately 4,300 hysterectomies and 3,200 operative hysteroscopies are performed in Denmark. Since the establishment of the database in 2003, 50,000 hysterectomies have been registered. DHHD's nationwide cooperation and research have led to national guidelines and regimes. Annual national meetings and nationwide workshops have been organized.
The use of vaginal and laparoscopic hysterectomy methods has increased during the past decade and the overall complication rate and hospital stay have declined. The regional variation in operation methods has also decreased.
丹麦子宫切除术和宫腔镜检查数据库(DHHD)的指导委员会已明确该数据库的目标:首先是减少并发症、再入院率和再次手术;其次是明确子宫切除术后的住院需求;第三是通过制定标准和国家指南确保子宫切除术和宫腔镜检查的质量评估;最后是加强对腹腔镜手术的监测并探索子宫切除术后的长期副作用。
我们纳入了自2003年以来在丹麦接受择期良性子宫手术的所有女性。手术包括子宫切除术和手术宫腔镜检查。对于后者,我们纳入了子宫内膜切除术、黏膜下平滑肌瘤切除术以及子宫内膜消融术。
有关子宫切除术和宫腔镜检查手术技术、合作情况及适应证的详细信息直接记录在国家患者登记册(NPR)中,还有相关的生活方式因素和混杂因素。在NPR中记录并发症和再入院信息是强制性的。DHHD中包含的数据直接从NPR中提取。
丹麦每年大约进行4300例子宫切除术和3200例手术宫腔镜检查。自2003年数据库建立以来,已登记了50000例子宫切除术。DHHD在全国范围内的合作与研究促成了国家指南和制度的出台。已组织了年度全国会议和全国性研讨会。
在过去十年中,阴道和腹腔镜子宫切除术方法的使用有所增加,总体并发症发生率和住院时间有所下降。手术方法的地区差异也有所减少。