Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Center for Clinical Research Dalarna, Falun, Sweden.
Acta Obstet Gynecol Scand. 2018 Dec;97(12):1463-1470. doi: 10.1111/aogs.13450. Epub 2018 Oct 7.
There is a paucity of data on the impact of organ injury on long-term outcomes after a hysterectomy for benign indications. The aim of this study was to investigate fistula formation and patient-reported long-term health outcomes after organ injury at the time of a hysterectomy.
This was a population-based study of 22 538 women undergoing a hysterectomy between 2000 and 2014 in Sweden. Their medical history, characteristics of their surgery, and patient-reported outcomes were retrieved from Swedish national health and quality registers. Predictors for fistula formation were investigated with logistic regression and are presented as odds ratios with a 95% CI.
Fistulas were reported in 7% of women with organ injuries, compared with 0.4% of those without organ injuries (adjusted odds ratio 15.29 [9.81-23.85]). Laparotomy and postoperative infection were associated with postoperative fistulas. Most of the women reported having better health 1 year after the hysterectomy, but 7% of those with organ injuries and 24% of those with fistulas reported deteriorated health, compared with 2% of women without injuries.
Organ injury at the time of hysterectomy is associated with the development of fistulas involving the female genital tract and increases the proportion of women reporting deteriorated health 1 year after surgery.
关于良性指征行子宫切除术对长期结局的器官损伤影响，相关数据匮乏。本研究旨在调查在子宫切除术中发生器官损伤后瘘的形成和患者报告的长期健康结局。
这是一项在瑞典进行的 22538 名女性的基于人群的研究，她们于 2000 年至 2014 年间行子宫切除术。从瑞典国家健康和质量登记处获取了她们的病史、手术特征和患者报告的结局。使用逻辑回归调查瘘的形成预测因素，并以 95%置信区间表示比值比。
有器官损伤的女性中报告了 7%的瘘，而无器官损伤的女性中报告了 0.4%（调整比值比 15.29 [9.81-23.85]）。剖腹术和术后感染与术后瘘有关。大多数女性在子宫切除术后 1 年报告健康状况更好，但有器官损伤的女性中有 7%和有瘘的女性中有 24%报告健康状况恶化，而无损伤的女性中只有 2%。
子宫切除术中的器官损伤与女性生殖道瘘的发生有关，并增加了术后 1 年报告健康状况恶化的女性比例。
