Thurston Jackie, Murji Ally, Scattolon Sarah, Wolfman Wendy, Kives Sari, Sanders Ari, Leyland Nicholas
Calgary, AB.
Toronto, ON.
J Obstet Gynaecol Can. 2019 Apr;41(4):543-557. doi: 10.1016/j.jogc.2018.12.006.
To assist physicians performing gynaecologic surgery in decision making surrounding hysterectomy for benign indications.
Physicians, including gynaecologists, obstetricians, family physicians, general surgeons, emergency medicine specialists; nurses, including registered nurses and nurse practitioners; medical trainees, including medical students, residents, and fellows; and all other health care providers.
Adult women (18 years and older) who will undergo hysterectomy for benign gynaecologic indications.
The approach to hysterectomy and utility of concurrent surgical procedures are reviewed in this guideline.
For this guideline relevant studies were searched in the PubMed, Medline, and Cochrane Library databases. The following MeSH search terms and their variations for the last 5 years (2012-2017) were used: vaginal hysterectomy, laparoscopic hysterectomy, robotic hysterectomy, laparoscopically assisted vaginal hysterectomy, total laparoscopic hysterectomy, standard vaginal hysterectomy, and total vaginal hysterectomy.
The content and recommendations were drafted and agreed upon by the principal authors and members of the Gynaecology Committee. The Board of the Society of Obstetricians and Gynaecologists of Canada approved the final draft for publication. The quality of evidence was rated using the criteria described in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology framework (Tables 1 and 2). The Summary of Findings is available upon request.
BENEFITS, HARMS, AND COSTS: Hysterectomy is common, yet surgical practice still varies widely among gynaecologic physicians. This guideline outlines preoperative and perioperative considerations to improve the quality of care for women undergoing benign gynaecologic surgery.
This Society of Obstetricians and Gynaecologists of Canada clinical practice guideline will be automatically reviewed 5 years after publication. However, authors can propose another review date if they feel that 5 years is too short/long based on their expert knowledge of the subject matter.
This guideline was developed with resources funded by the Society of Obstetricians and Gynaecologists of Canada.
RECOMMENDATIONS.
协助进行妇科手术的医生在因良性指征行子宫切除术时做出决策。
医生，包括妇科医生、产科医生、家庭医生、普通外科医生、急诊医学专家；护士，包括注册护士和执业护士；医学实习生，包括医学生、住院医师和研究员；以及所有其他医疗保健提供者。
因良性妇科指征将接受子宫切除术的成年女性（18岁及以上）。
本指南回顾了子宫切除术的方法及同期手术操作的实用性。
为制定本指南，在PubMed、Medline和Cochrane图书馆数据库中检索了相关研究。使用了过去5年（2012 - 2017年）以下医学主题词及其变体：阴道子宫切除术、腹腔镜子宫切除术、机器人辅助子宫切除术、腹腔镜辅助阴道子宫切除术、全腹腔镜子宫切除术、标准阴道子宫切除术和全阴道子宫切除术。
内容和建议由主要作者及妇科委员会成员起草并商定。加拿大妇产科医师协会理事会批准了最终出版草案。使用推荐分级评估、制定和评价（GRADE）方法框架中描述的标准对证据质量进行评级（表1和表2）。如有需要可提供研究结果总结。
益处、危害和成本：子宫切除术很常见，但妇科医生的手术操作仍存在很大差异。本指南概述了术前和围手术期的注意事项，以提高接受良性妇科手术女性的护理质量。
本加拿大妇产科医师协会临床实践指南将在出版后5年自动进行审查。然而，如果作者基于其对该主题的专业知识认为5年太短/太长，可提议另一个审查日期。
本指南是利用加拿大妇产科医师协会提供的资源制定的。
建议。
