Bonde Lisbeth, Noer Mette Calundann, Møller Lars Alling, Ottesen Bent, Gimbel Helga
Department of Obstetrics and Gynecology, Nykoebing Falster Hospital, Nykoebing Falster, Denmark.
University of Southern Denmark, Odense, Denmark.
Int Urogynecol J. 2017 Jul;28(7):1067-1075. doi: 10.1007/s00192-016-3229-8. Epub 2016 Dec 20.
Several suspension methods are used to try to prevent pelvic organ prolapse (POP) after hysterectomy. We aimed to evaluate agreement on terminology and surgical procedure of these methods.
We randomly chose 532 medical records of women with a history of hysterectomy from the Danish Hysterectomy and Hysteroscopy Database (DHHD). Additionally, we video-recorded 36 randomly chosen hysterectomies. The hysterectomies were registered in the DHHD. The material was categorized according to predefined suspension methods. Agreement compared suspension codes in DHHD (gynecologists' registrations) with medical records (gynecologists' descriptions) and with videos (reviewers' categorizations) respectively. Whether the vaginal vault was suspended (pooled suspension) or not (no suspension method + not described) was analyzed, in addition to each suspension method.
Regarding medical records, agreement on terminology was good among patients undergoing pooled suspension in cases of hysterectomy via the abdominal and vaginal route (agreement 78.7, 92.3%). Regarding videos, agreement on surgical procedure was good among pooled suspension patients in cases of hysterectomy via the abdominal, laparoscopic, and vaginal routes (agreement 88.9, 97.8, 100%). Agreement on individual suspension methods differed regarding both medical records (agreement 0-90.1%) and videos (agreement 0-100%).
Agreement on terminology and surgical procedure regarding suspension method was good in respect of pooled suspension. However, disagreement was observed when individual suspension methods and operative details were scrutinized. Better consensus of terminology and surgical procedure is warranted to enable further research aimed at preventing POP among women undergoing hysterectomy.
有几种悬吊方法被用于尝试预防子宫切除术后盆腔器官脱垂（POP）。我们旨在评估这些方法在术语和手术操作方面的一致性。
我们从丹麦子宫切除术和宫腔镜检查数据库（DHHD）中随机选取了532例有子宫切除史的女性的医疗记录。此外，我们对36例随机选取的子宫切除术进行了视频记录。这些子宫切除术已在DHHD中登记。材料根据预先定义的悬吊方法进行分类。一致性分别比较了DHHD中的悬吊编码（妇科医生的登记）与医疗记录（妇科医生的描述）以及与视频（评审员的分类）。除了每种悬吊方法外，还分析了阴道穹窿是否被悬吊（汇总悬吊）或未被悬吊（无悬吊方法 + 未描述）。
关于医疗记录，在经腹和经阴道途径子宫切除术中接受汇总悬吊的患者中，术语一致性良好（一致性分别为78.7%、92.3%）。关于视频，在经腹、腹腔镜和经阴道途径子宫切除术中接受汇总悬吊的患者中，手术操作一致性良好（一致性分别为88.9%、97.8%、100%）。关于个体悬吊方法的一致性在医疗记录（一致性为0 - 90.1%）和视频（一致性为0 - 100%）方面均有所不同。
关于悬吊方法的术语和手术操作在汇总悬吊方面一致性良好。然而，在仔细审查个体悬吊方法和手术细节时发现存在分歧。有必要在术语和手术操作上达成更好的共识，以便开展进一步研究，旨在预防子宫切除术后女性的盆腔器官脱垂。
