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Tytuł pozycji:

Vaginal cuff closure after minimally invasive hysterectomy: our experience and systematic review of the literature.

Tytuł:
Vaginal cuff closure after minimally invasive hysterectomy: our experience and systematic review of the literature.
Autorzy:
Uccella S; Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy. />Ghezzi F
Mariani A
Cromi A
Bogani G
Serati M
Bolis P
Źródło:
American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2011 Aug; Vol. 205 (2), pp. 119.e1-12. Date of Electronic Publication: 2011 Mar 22.
Typ publikacji:
Comparative Study; Journal Article; Review; Systematic Review
Język:
English
Imprint Name(s):
Publication: <2005->: New York : Elsevier
Original Publication: St. Louis.
MeSH Terms:
Hysterectomy/*adverse effects
Laparoscopy/*adverse effects
Robotics/*methods
Surgical Wound Dehiscence/*surgery
Vagina/*surgery
Adult ; Aged ; Cohort Studies ; Confidence Intervals ; Female ; Follow-Up Studies ; Humans ; Hysterectomy/methods ; Laparoscopy/methods ; Middle Aged ; Odds Ratio ; Retrospective Studies ; Risk Assessment ; Surgical Wound Dehiscence/etiology ; Suture Techniques/adverse effects ; Treatment Outcome ; Uterine Diseases/pathology ; Uterine Diseases/surgery ; Uterine Neoplasms/pathology ; Uterine Neoplasms/surgery
Entry Date(s):
Date Created: 20110531 Date Completed: 20120124 Latest Revision: 20220321
Update Code:
20240104
DOI:
10.1016/j.ajog.2011.03.024
PMID:
21620360
Czasopismo naukowe
Objective: To determine the incidence of vaginal cuff dehiscence after minimally invasive hysterectomy, we reported our series of total laparoscopic hysterectomies with transvaginal colporraphy.
Study Design: We then conducted a systematic search of PubMed to retrieve published series of laparoscopic and robotic hysterectomies, in which different techniques for vaginal cuff closure were used.
Results: In our study group, vaginal cuff dehiscence occurred in 2 of 665 (0.3%) patients. Our literature search identified 57 articles, for a total of 13,030 endoscopic hysterectomies. Ninety-one postoperative vaginal separations were reported (0.66%). The pooled incidence of vaginal dehiscence was lower for transvaginal cuff closure (0.18%) than for both laparoscopic (0.64%; odds ratio [OR], 0.28; 95% confidence interval [CI], 0.12-0.65) and robotic (1.64%; OR, 0.11; 95% CI, 0.04-0.26) colporraphy. Laparoscopic cuff closure was associated with a lower risk of dehiscence than robotic closure (OR, 0.38; 95% CI, 0.28-0.6).
Conclusion: Current evidence indicates that transvaginal colporraphy after total laparoscopic hysterectomy is associated with a 3- and 9-fold reduction in risk of vaginal cuff dehiscence compared with laparoscopic and robotic suture, respectively.
(Copyright © 2011 Mosby, Inc. All rights reserved.)
Comment in: Am J Obstet Gynecol. 2012 Mar;206(3):e10; author reply e10-1. (PMID: 22118963)

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