Orhan Adnan, Ozerkan Kemal, Kasapoglu Isil, Ocakoglu Gokhan, Cetinkaya Demir Bilge, Gunaydin Tuba, Uncu Gurkan
Department of Obstetrics and Gynecology, Uludag University Hospital, Bursa, Turkey.
Department of Obstetrics and Gynecology, Uludag University Hospital, Bursa, Turkey.
J Gynecol Obstet Hum Reprod. 2019 Dec;48(10):791-798. doi: 10.1016/j.jogoh.2019.06.007. Epub 2019 Jul 26.
To investigate the effect of challenging factors on laparoscopic hysterectomy trends within twenty-four years.
This was a trend analysis study of 7558 women who underwent hysterectomy for benign indications between 1995-2018 in Bursa Uludag University Hospital, Turkey. A trend analysis of obesity, previous laparotomy (≥3) and uterine specimen weight (≥500g) was applied for abdominal hysterectomy (TAH), vaginal hysterectomy (VH), and laparoscopic hysterectomy (TLH) rates in this period. The primary outcome was laparoscopic hysterectomy trends throughout the years. We measured the effect of obesity, previous laparotomies and large uterus on TLH trends as secondary outcomes.
The ratio of TLHs to all hysterectomies was 2.4% in 1995 and 44.7% in 2018 which increased 33 times higher over 24 years. The percentage of obese patients in TLH cases increased from 1% to 37%, the rate of patients who had three or more previous laparotomy in TLH cases increased from 0% to 32.2%, and the percentage of patients who had more than 500g uterus specimen in laparoscopic hysterectomy cases increased from 0% to 32.8%.
Laparoscopic hysterectomy trends are increasing in challenging cases. Obesity, previous surgeries, and large uteruses are no longer a limiting factor for laparoscopic hysterectomy.
探讨24年内具有挑战性的因素对腹腔镜子宫切除术趋势的影响。
这是一项对土耳其布尔萨乌鲁达大学医院1995年至2018年间因良性指征接受子宫切除术的7558名女性进行的趋势分析研究。对该时期腹式子宫切除术（TAH）、阴道子宫切除术（VH）和腹腔镜子宫切除术（TLH）的肥胖、既往剖腹手术（≥3次）和子宫标本重量（≥500g）进行趋势分析。主要结局是多年来腹腔镜子宫切除术的趋势。我们将肥胖、既往剖腹手术和子宫较大对TLH趋势的影响作为次要结局进行测量。
1995年TLH占所有子宫切除术的比例为2.4%，2018年为44.7%，24年间增长了33倍。TLH病例中肥胖患者的比例从1%增至37%，TLH病例中既往有三次或更多次剖腹手术的患者比例从0%增至32.2%，腹腔镜子宫切除术病例中子宫标本重量超过500g的患者比例从0%增至32.8%。
在具有挑战性的病例中，腹腔镜子宫切除术的趋势正在增加。肥胖、既往手术和子宫较大不再是腹腔镜子宫切除术的限制因素。
