Öz
Aim: In this study, we aimed to compare conventional Heaney’s method and the Ten-Step Vaginal Hysterectomy method and to analyse the effects of the both techniques on the clinical outcomes.
Material and Methods: Forty-nine patients who underwent vaginal hysterectomy with the diagnosis of uterine prolapses were retrospectively evaluated. Among them, 24 patients had underwent the conventional Heaney’s method and 25 patients had underwent the Ten-Step Vaginal Hysterectomy method. The age, body mass index (BMI), number of pregnancies, number of live births, pre- and post-operative levels of haemoglobin, operation time, duration of hospitalization and analgesic requirement period were compared in both methods.
Results: The averages of ages, BMI, numbers of pregnancies, number of live births, pre- and post-operative haemoglobin levels were similar in both methods (P > 0.05). But the patients who underwent Ten-Step Vaginal Hysterectomy method had a significantly shorter operation time (P = 0.001), shorter hospital stay (P = 0.020) and shorter time of analgesics requirement (P = 0.006).
Conclusion: We concluded that in terms of operation time, hospital stay and analgesic requirement, the Ten-Step Vaginal Hysterectomy method had better clinical outcome than the conventional Heaney’s method.
Key words: Vaginal Hysterectomy; Conventional Heaney’s Method; Ten-Steps Method; Clinical Outcomes
Anahtar Kelimeler
Kaynakça
- John A R, John D T, Te Linde‘s Operative Gynaecology:Edition Lippincott-Raven Publishers: Philadelphia-Newyork: 1997; 33;771-5.
- Summitt Jr RL, Stovall TG, Lipscomb GH, Ling FW. Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol 1992; 80: 895-901.
- Kalogirou D, Antoniou G, Zioris C, Fotopoulos S, Karakitsos P. Vaginal hysterectomy: technique and results in the last twenty years. J Gynecol Surg 1995; 11: 201-7.
- Stark M, Gerli S, Di Renzo GC. An example for an optimized technique: the ten-step vaginal hysterectomy. Progress in Obstetric and Gyanecology 2006; 17: 358-68.
- Claerhout F, Deprest J. Laparoscopic hysterectomy for benign diseases. Best Pract Res Clin Obstet Gynaecol 2005; 19: 357-75.
- Campbell ES, Xiao H, Smith MK. Types of hysterectomy. Comparison of characteristic, hospital costs, utilization and outcomes. J Repond Med 2003; 48: 943-9.
- Drahonovsky J, Haakova L, Otcenasek M, Krofta L, Kucera E, Feyereisl J. A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy and total laparoscopic hysterectomy in women with benign uterine disease. Eur J Obstet Gynecol Reprod Biol. 2010; 148: 172-6.
- American College of Obstetricians and Gynecologists: Appropriate use of laparoscopically assisted vaginal hysterectomy. Obstet Gynecol 2005; 105: 929-30.
- Meikle SF, Nugent EW, Orleans M. Complications and recovery from laparoscopy assisted vaginal hysterectomy compared with abdominal and vaginal hysterectomy. Obstet Gynecol 1997; 89: 304-11.
- Doucette RC, Sharp HT, Alder SC. Challenging generally accepted contraindications to vaginal hysterectomy. Am J Obstet Gynecol 2001; 184: 1386-9.
- Dhainaut C, Salomon LJ, Junger M, Marcollet A, Madelenat P. Hysterectomies in patients with no history of vaginal delivery. A study of 243 cases. Gynecol Obstet Fertil 2005; 33: 11-6.
- Li Z, Leng J, Lang J, Tang J. Vaginal hysterectomy for patients with moderately enlarged uterus of benign lesions. Chin Med Sci J 2004; 19: 60-3.
- The American College of Obstetricians and Gynecologists (ACOG) Abdominal or laparoscopically assisted vaginal hysterectomy. ACOG Recommends Vaginal Hysterectomy November issue of Obstetrics & Gynecology, 22.10.09.
- Paldi E, Fimar S, Naiger R, Weisseman A, Feldman EJ. Vaginal hysterectomy using the Porges method. Report on 100 cases. J Gynecol Obster Biol Reprod 1988; 17: 233-6.
- Falk HC, Soichet S. The technique of vaginal hysterectomy, Clin Obstet Gynecol 1972; 15: 703-54.
- Von Theobald P. Simplified vaginal hysterectomy. J Chir 2001;138: 93-8.
- Kalogirou D, Antoniou G, Zioris C, Folopoulos S, Karakitsos P. Vaginal hysterectomy: technique and results in the last twenty years. J Gynecol Surg 1995; 11: 201-7.
- Lash AF, Stepto RC. Chicago technique for vaginal hysterectomy at the Cook County Hospital. Clin Obstet Gynecol 1972; 15: 755-68.
- Kudo R, Yamauchi O, Okazaki T, Sagae S, Ito E, Hashimoto M. Vaginal hysterectomy without ligation of the ligaments of the cervix uteri. Surg Gynecol Obstet 1990; 170: 299-305.
- Ellis H. Internal overhealing: the problem of intraperitoneal adhesions. World J Surg 1980; 4: 303-6.
- Stark M. Clinical evidence that suturing the peritoneum after laparotomy is unnecessary for healing. World J Surg 1993; 17: 419.
- Janschek EC, Hohlagschwandtner M, Nather A, Schindl M, Joura EA. A study of nonclosure of the peritoneum at vaginal hysterectomy. Arch Gynecol Obstet 2003; 267: 213-6.
- Miskry T, Magos A. Mass closure: a new technique for closure of the vaginal vault at vaginal hysterectomy. Br J Obstet Gynaecol 2001; 108: 1295-7.
- Heaney NS. Vaginal hysterectomy–its indications and technique. Am J Surg 1940; 56: 284-8.
- Bina I, Akhter D. The ten-step vaginal hysterectomy-a newer and beter approach. J Bangladesh Coll Phys Surg 2012; 30: 71-7.
Öz
Amaç: Bu çalışmada vajinal histerektomi uygulanmış hastalarda Konvansiyonel Heaney tekniği ile On-Basamak Vajinal Histerektomi tekniğinin karşılaştırılması ve bu tekniklerin klinik sonuçlar üzerine etkisinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler:Uterin prolapsus nedeniyle vajinal histerektomi yapılmış 49 hasta retrospektif olarak değerlendirildi. Bu hastaların 24’üne konvansiyonel Heaney tekniği, 25’ine ise yeni On-Basamak Vajinal Histerektomi tekniği uygulanmıştı. Her iki teknik, yaş, vücut kitle endeksi (BMI), gebelik sayısı, canlı doğum sayısı, ameliyat öncesi ve sonrası hemoglobin düzeyleri, ameliyat süresi, hastanede kalış süresi ve analjezik gereksinim süresi açısından karşılaştırıldı.
Bulgular: Ortalama yaş, BMI, gebelik sayısı, canlı doğum sayısı, ameliyat öncesi ve sonrası hemoglobin düzeyleri iki grupta da benzerdi (P > 0,05). On-Basamak Vajinal Histerektomi tekniği uygulanmış hastalarda ameliyat süresinin (P = 0,001), hastane kalış süresinin (P = 0,020) ve analjezik gereksinim süresinin (P = 0,006) daha kısa olduğu saptandı.
Sonuçlar: Ameliyat süresi, hastanede kalış süresi ve analjezik gereksinim günleri açısından On-Basamak Vajinal Histerektomi tekniğinin klinik sonuçları konvansiyonel Heaney tekniğine göre daha iyi olarak değerlendirilmiştir.
Anahtar kelimeler: Vajinal Histerektomi; Konvansiyonel Heaney Tekniği; On-Basamak Tekniği; Klinik Sonuçlar
Anahtar Kelimeler
Vajinal Histerektomi; Konvansiyonel Heaney Tekniği; On-Basamak Tekniği; Klinik Sonuçlar
Kaynakça
- John A R, John D T, Te Linde‘s Operative Gynaecology:Edition Lippincott-Raven Publishers: Philadelphia-Newyork: 1997; 33;771-5.
- Summitt Jr RL, Stovall TG, Lipscomb GH, Ling FW. Randomized comparison of laparoscopy-assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol 1992; 80: 895-901.
- Kalogirou D, Antoniou G, Zioris C, Fotopoulos S, Karakitsos P. Vaginal hysterectomy: technique and results in the last twenty years. J Gynecol Surg 1995; 11: 201-7.
- Stark M, Gerli S, Di Renzo GC. An example for an optimized technique: the ten-step vaginal hysterectomy. Progress in Obstetric and Gyanecology 2006; 17: 358-68.
- Claerhout F, Deprest J. Laparoscopic hysterectomy for benign diseases. Best Pract Res Clin Obstet Gynaecol 2005; 19: 357-75.
- Campbell ES, Xiao H, Smith MK. Types of hysterectomy. Comparison of characteristic, hospital costs, utilization and outcomes. J Repond Med 2003; 48: 943-9.
- Drahonovsky J, Haakova L, Otcenasek M, Krofta L, Kucera E, Feyereisl J. A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy and total laparoscopic hysterectomy in women with benign uterine disease. Eur J Obstet Gynecol Reprod Biol. 2010; 148: 172-6.
- American College of Obstetricians and Gynecologists: Appropriate use of laparoscopically assisted vaginal hysterectomy. Obstet Gynecol 2005; 105: 929-30.
- Meikle SF, Nugent EW, Orleans M. Complications and recovery from laparoscopy assisted vaginal hysterectomy compared with abdominal and vaginal hysterectomy. Obstet Gynecol 1997; 89: 304-11.
- Doucette RC, Sharp HT, Alder SC. Challenging generally accepted contraindications to vaginal hysterectomy. Am J Obstet Gynecol 2001; 184: 1386-9.
- Dhainaut C, Salomon LJ, Junger M, Marcollet A, Madelenat P. Hysterectomies in patients with no history of vaginal delivery. A study of 243 cases. Gynecol Obstet Fertil 2005; 33: 11-6.
- Li Z, Leng J, Lang J, Tang J. Vaginal hysterectomy for patients with moderately enlarged uterus of benign lesions. Chin Med Sci J 2004; 19: 60-3.
- The American College of Obstetricians and Gynecologists (ACOG) Abdominal or laparoscopically assisted vaginal hysterectomy. ACOG Recommends Vaginal Hysterectomy November issue of Obstetrics & Gynecology, 22.10.09.
- Paldi E, Fimar S, Naiger R, Weisseman A, Feldman EJ. Vaginal hysterectomy using the Porges method. Report on 100 cases. J Gynecol Obster Biol Reprod 1988; 17: 233-6.
- Falk HC, Soichet S. The technique of vaginal hysterectomy, Clin Obstet Gynecol 1972; 15: 703-54.
- Von Theobald P. Simplified vaginal hysterectomy. J Chir 2001;138: 93-8.
- Kalogirou D, Antoniou G, Zioris C, Folopoulos S, Karakitsos P. Vaginal hysterectomy: technique and results in the last twenty years. J Gynecol Surg 1995; 11: 201-7.
- Lash AF, Stepto RC. Chicago technique for vaginal hysterectomy at the Cook County Hospital. Clin Obstet Gynecol 1972; 15: 755-68.
- Kudo R, Yamauchi O, Okazaki T, Sagae S, Ito E, Hashimoto M. Vaginal hysterectomy without ligation of the ligaments of the cervix uteri. Surg Gynecol Obstet 1990; 170: 299-305.
- Ellis H. Internal overhealing: the problem of intraperitoneal adhesions. World J Surg 1980; 4: 303-6.
- Stark M. Clinical evidence that suturing the peritoneum after laparotomy is unnecessary for healing. World J Surg 1993; 17: 419.
- Janschek EC, Hohlagschwandtner M, Nather A, Schindl M, Joura EA. A study of nonclosure of the peritoneum at vaginal hysterectomy. Arch Gynecol Obstet 2003; 267: 213-6.
- Miskry T, Magos A. Mass closure: a new technique for closure of the vaginal vault at vaginal hysterectomy. Br J Obstet Gynaecol 2001; 108: 1295-7.
- Heaney NS. Vaginal hysterectomy–its indications and technique. Am J Surg 1940; 56: 284-8.
- Bina I, Akhter D. The ten-step vaginal hysterectomy-a newer and beter approach. J Bangladesh Coll Phys Surg 2012; 30: 71-7.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Özgün Makale |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Ekim 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 6 Sayı: 3 |
Kaynak Göster
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