Sandberg Evelien M, Hehenkamp Wouter J K, Geomini Peggy M, Janssen Petra F, Jansen Frank Willem, Twijnstra Andries R H
Section Minimally Invasive Gynecologic Surgery, Department of Gynecology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Department of Gynecology, VU University Medical Center, Amsterdam, The Netherlands.
Arch Gynecol Obstet. 2017 Sep;296(3):597-606. doi: 10.1007/s00404-017-4467-9. Epub 2017 Jul 26.
Since the introduction of minimally invasive gynecologic surgery, the percentage of advanced laparoscopic procedures has greatly increased worldwide. It seems therefore, timely to standardize laparoscopic gynecologic care according to the principles of evidence-based medicine. With this goal in mind-the Dutch Society of Gynecological Endoscopic Surgery initiated in The Netherlands the development of a national guideline for laparoscopic hysterectomy (LH). This present article provides a summary of the main recommendations of the guideline.
This guideline was developed following the Dutch guideline of medical specialists and in accordance with the AGREE II tool. Clinically important issues were firstly defined and translated into research questions. A literature search per topic was then conducted to identify relevant articles. The quality of the evidence of these articles was rated following the GRADE systematic. An expert panel consisting of 18 selected gynecologists was consulted to formulate best practice recommendations for each topic.
Ten topics were considered in this guideline, including amongst others, the different approaches for hysterectomy, advice regarding tissue extraction, pre-operative medical treatment and prevention of ureter injury. This work resulted in the development of a clinical practical guideline of LH with evidence- and expert-based recommendations. The guideline is currently being implemented in The Netherlands.
A guideline for LH was developed. It gives an overview of best clinical practice recommendations. It serves to standardize care, provides guidance for daily practice and aims to guarantee the quality of LH at an (inter)national level.
自从微创妇科手术引入以来，先进腹腔镜手术的比例在全球范围内大幅增加。因此，根据循证医学原则规范腹腔镜妇科护理似乎很及时。出于这一目的，荷兰妇科内镜外科学会在荷兰启动了腹腔镜子宫切除术（LH）国家指南的制定工作。本文提供了该指南主要建议的总结。
本指南是按照荷兰医学专家指南并依据AGREE II工具制定的。首先确定临床重要问题并转化为研究问题。然后针对每个主题进行文献检索以识别相关文章。按照GRADE系统对这些文章的证据质量进行评级。咨询了由18名选定妇科医生组成的专家小组，为每个主题制定最佳实践建议。
本指南考虑了十个主题，其中包括子宫切除术的不同方法、组织取出建议、术前药物治疗以及输尿管损伤的预防等。这项工作形成了一个基于证据和专家建议的LH临床实用指南。该指南目前正在荷兰实施。
制定了LH指南。它概述了最佳临床实践建议。它有助于规范护理，为日常实践提供指导，并旨在在国家（或国际）层面保证LH的质量。
