Agarwal Mukta, Sinha Shivangni, Haripriya H, Kokkayil Prathyusha, Singh Shruti
Department of Obstetrics and Gynecology, AIIMS, Patna, Bihar, India.
Department of Family and Community Medicine, AIIMS, Patna, Bihar, India.
Gynecol Minim Invasive Ther. 2023 Dec 11;13(1):25-29. doi: 10.4103/gmit.gmit_56_23. eCollection 2024 Jan-Mar.
Surgical site infection (SSI) is an unsettled complication seen in any surgery. The aim of this study is to assess the rate of postoperative SSIs between total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH). Can the rate of SSI be reduced with the use of a laparoscopic mode of hysterectomy over abdominal?
It was a retrospective comparative study. The study was conducted in the obstetrics and gynecology department at a tertiary care center from June 2016 to March 2020. A total of 300 patients who underwent hysterectomy either via laparoscopic or abdominal route were included in the study. They were subdivided into two groups: a total of 167 underwent TLH (Group 1) and 133 had TAH (Group 2). The results were compared. It included the age and body mass index of the patient, indication of surgery, size of the uterus, intraoperative blood loss, postoperative SSIs, duration of hospital stay, and readmission rates.
It was found a high rate of SSI in TAH (82.4% vs. 17.6%, < 0.001, Cramer's V-0.18), the operative time taken (75 ± 25 min vs. 128 ± 52 min, < 0.001), and the mean blood loss during TLH (110 ± 30 ml vs. 160 ± 116 ml, < 0.001) was found significant for patients. The hospital stay after TLH was found to be significantly shorter (4 ± 2.47 days vs. 7 ± 2.43, < 0.001).
TLH has improved the psychological, physical, and financial burden on the health care department. Thus, it has proved a preferred route over TAH.
手术部位感染(SSI)是任何手术中都存在的一个未解决的并发症。本研究的目的是评估全腹腔镜子宫切除术(TLH)和经腹全子宫切除术(TAH)术后手术部位感染的发生率。与经腹子宫切除术相比,采用腹腔镜子宫切除术模式能否降低手术部位感染率?
这是一项回顾性比较研究。该研究于2016年6月至2020年3月在一家三级医疗中心的妇产科进行。共有300例行腹腔镜或经腹子宫切除术的患者纳入研究。他们被分为两组:167例行TLH(第1组),133例行TAH(第2组)。对结果进行比较。比较内容包括患者的年龄、体重指数、手术指征、子宫大小、术中失血、术后手术部位感染、住院时间和再入院率。
发现TAH的手术部位感染率较高(82.4%对17.6%,<0.001,克莱默V值为0.18),手术时间(75±25分钟对128±52分钟,<0.001),TLH期间的平均失血量(110±30毫升对160±116毫升,<0.001)对患者有显著意义。发现TLH后的住院时间明显更短(4±2.47天对7±2.43天,<0.001)。
TLH减轻了医疗部门的心理、身体和经济负担。因此,它已被证明是优于TAH的首选手术途径。