Adnan Orhan1, Kemal Ozerkan2, Isil Kasapoglu2, Gokhan Ocakoglu3, Bilge Cetinkaya Demir2, Tuba Gunaydin2, Gurkan Uncu2. 1. Department of Obstetrics and Gynecology, Uludag University Hospital, Bursa, Turkey. Electronic address: adnanorhan@uludag.edu.tr. 2. Department of Obstetrics and Gynecology, Uludag University Hospital, Bursa, Turkey. 3. Department of Biostatistics, Uludag University Hospital, Bursa, Turkey.
Abstract
OBJECTIVE: To investigate the effect of challenging factors on laparoscopic hysterectomy trends within twenty-four years. POPULATION AND METHOD: 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. RESULTS: 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%. CONCLUSION: Laparoscopic hysterectomy trends are increasing in challenging cases. Obesity, previous surgeries, and large uteruses are no longer a limiting factor for laparoscopic hysterectomy.
OBJECTIVE: To investigate the effect of challenging factors on laparoscopic hysterectomy trends within twenty-four years. POPULATION AND METHOD: 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. RESULTS: 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 obesepatients 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%. CONCLUSION: Laparoscopic hysterectomy trends are increasing in challenging cases. Obesity, previous surgeries, and large uteruses are no longer a limiting factor for laparoscopic hysterectomy.
Authors: Florian Ebner; Niko de Gregorio; Christiane Lato; Valerie Ohly; Wolfgang Janni; Jennifer Spohrs; Lucia Jerg-Bretzke; Steffen Walter Journal: Front Med (Lausanne) Date: 2020-11-25