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21. Systematic review with meta analysis: Vaginal hysterectomy is the best minimal access method for hysterectomy

Systematic review with meta analysis: Vaginal hysterectomy is the best minimal access method for hysterectomy Vaginal hysterectomy is the best minimal access method for hysterectomy | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers (...) of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Vaginal hysterectomy is the best minimal access method for hysterectomy Article Text Therapeutics/Prevention Systematic review with meta analysis Vaginal hysterectomy is the best minimal access method for hysterectomy

2015 Evidence-Based Medicine (Requires free registration)

22. Total Laparoscopic Hysterectomy vs Total Abdominal Hysterectomy and Disease-Free Survival Among Women With Stage I Endometrial Cancer

Total Laparoscopic Hysterectomy vs Total Abdominal Hysterectomy and Disease-Free Survival Among Women With Stage I Endometrial Cancer Total Laparoscopic Hysterectomy vs Total Abdominal Hysterectomy and Disease-Free Survival Among Women With Stage I Endometrial Cancer – Less Is More Search for: Simpler & Better Medicine Menu / Summary: For women with stage I endometrial cancer, laparoscopic hysterectomy appears to be associated with the same likelihood of overall survival and disease-free (...) survival at 4.5 years as total abdominal hysterectomy, while laparoscopic hysterectomy may be associated with fewer postoperative surgical complications. Strength of Recommendation = B Advertisements Like this: Like Loading... Categories: Tags: Post navigation Simpler, Better Medicine Indexing evidence for "less medical” approaches with better outcomes. Recent entries Search by key words Search for: Search By Strength of Recommendation (SOR) (42) (244) (27) Search by clinical category For regular

2017 Less Is More Blog

23. Total laparoscopic hysterectomy versus total abdominal hysterectomy for endometrial cancer: a meta-analysis

Total laparoscopic hysterectomy versus total abdominal hysterectomy for endometrial cancer: a meta-analysis Total laparoscopic hysterectomy versus total abdominal hysterectomy for endometrial cancer: a meta-analysis Total laparoscopic hysterectomy versus total abdominal hysterectomy for endometrial cancer: a meta-analysis Wang HL, Ren YF, Yang J, Qin RY, Zhai KH CRD summary This review concluded there was new evidence of a benefit of total laparoscopic hysterectomy over total abdominal (...) hysterectomy for major complications, total complications and postoperative complications in women with endometrial cancer. The authors' conclusions appear to follow from the results, but should be viewed with caution due to small numbers of patients and lack of clarity about included trial quality. Authors' objectives To investigate the effects of total laparoscopic hysterectomy versus total abdominal hysterectomy in women with early-stage endometrial cancer. Searching PubMed, EMBASE, CBM (Chinese

2013 DARE.

24. Choosing the Route of Hysterectomy for Benign Disease

Choosing the Route of Hysterectomy for Benign Disease Choosing the Route of Hysterectomy for Benign Disease - ACOG Menu ▼ Choosing the Route of Hysterectomy for Benign Disease Page Navigation ▼ Number 701, June 2017 (Replaces Committee Opinion Number 444, November 2009) Committee on Gynecologic Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice in collaboration with committee members Kristen A. Matteson, MD (...) , MPH and Samantha F. Butts, MD, MSCE. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Choosing the Route of Hysterectomy for Benign Disease ABSTRACT: Hysterectomy is one of the most frequently performed surgical procedures in the United States. Selection of the route of hysterectomy for benign causes can be influenced

2017 American College of Obstetricians and Gynecologists

25. Total Laparoscopic Hysterectomy With Sacrocolpopexy Versus Total Laparoscopic Hysterectomy With Lateral Suspension in Patients With Pelvic Organ Prolapse

Total Laparoscopic Hysterectomy With Sacrocolpopexy Versus Total Laparoscopic Hysterectomy With Lateral Suspension in Patients With Pelvic Organ Prolapse Total Laparoscopic Hysterectomy With Sacrocolpopexy Versus Total Laparoscopic Hysterectomy With Lateral Suspension in Patients With Pelvic Organ Prolapse - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail (...) Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Total Laparoscopic Hysterectomy With Sacrocolpopexy Versus Total Laparoscopic Hysterectomy With Lateral Suspension in Patients With Pelvic Organ Prolapse The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government

2018 Clinical Trials

26. Disease-Free and Survival Outcomes for Total Laparoscopic Hysterectomy Compared With Total Abdominal Hysterectomy in Early-Stage Endometrial Carcinoma: A Meta-analysis.

Disease-Free and Survival Outcomes for Total Laparoscopic Hysterectomy Compared With Total Abdominal Hysterectomy in Early-Stage Endometrial Carcinoma: A Meta-analysis. Laparoscopic hysterectomy is currently offered to a large number of patients, and assessing the noninferiority to abdominal hysterectomy with respect to clinical outcomes is key. We examine rates of recurrence, disease-free survival (DFS), and overall survival, and surgical complications of laparoscopic compared with abdominal (...) hysterectomy for the treatment of early-stage endometrial cancer.Electronic databases were systematically searched to identify relevant studies, and patient characteristics and clinical outcomes extracted. The primary outcome was 3-year DFS, and estimates were pooled using an inverse-variance weighted meta-analysis.Nine studies (4405 patients) were identified in which DFS was reported in 5 studies. The difference in 3-year DFS was 1.44% (95% confidence interval [CI], -0.65% to 3.53%) in favor of total

2018 International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

27. Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy in Women With Endometrial Neoplasia

Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy in Women With Endometrial Neoplasia Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy in Women With Endometrial Neoplasia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100 (...) ). Please remove one or more studies before adding more. Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy in Women With Endometrial Neoplasia The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03698604 Recruitment Status : Completed First Posted : October 8, 2018 Last Update Posted

2018 Clinical Trials

28. Postoperative outcomes of natural orifice transluminal endoscopic surgery-assisted vaginal hysterectomy and conventional laparoscopic-assisted vaginal hysterectomy: a comparative study (PubMed)

Postoperative outcomes of natural orifice transluminal endoscopic surgery-assisted vaginal hysterectomy and conventional laparoscopic-assisted vaginal hysterectomy: a comparative study The present study aimed to determine the differences in outcomes between natural orifice transluminal endoscopic surgery-assisted vaginal hysterectomy (NAVH) and conventional laparoscopy-assisted vaginal hysterectomy (LAVH).We retrospectively reviewed the charts of patients who between July 2012 and September (...) the groups in terms of other variables.NAVH may become a new alternative surgical method of choice for hysterectomy, as it represents a clinically feasible and safe approach; moreover is superior to LAVH in terms of bleeding loss.

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2018 Obstetrics & gynecology science

29. Vaginal cuff dehiscence is observed in a higher rate after total laparoscopic hysterectomy compared to other types of hysterectomy. (PubMed)

Vaginal cuff dehiscence is observed in a higher rate after total laparoscopic hysterectomy compared to other types of hysterectomy. Recently, it has been suggested that the occurrence of posthysterectomy vaginal cuff dehiscence has increased. Consequently, we evaluated the incidence of vaginal cuff dehiscence after different types of hysterectomies. Our hypothesis is that vaginal cuff dehiscence is more often associated with total laparoscopic hysterectomy (TLH) than other types of uterine (...) removal.A total of 13 645 hysterectomies from 1992 to 2015 were evaluated in the Turku University Hospital district, Finland. The primary outcome was occurrence of vaginal dehiscence after different types of hysterectomy. The hysterectomy and postoperative vaginal dehiscence trends were analyzed as the secondary outcome. In a subanalysis of dehiscence cases, women's characteristics and perioperative vaginal cuff opening and closure techniques were compared between conventional hysterectomies (vaginal

2018 Acta Obstetricia et Gynecologica Scandinavica

30. Vaginal hysterectomy versus laparoscopically assisted vaginal hysterectomy for large uteri between 280 and 700 g: a randomized controlled trial. (PubMed)

Vaginal hysterectomy versus laparoscopically assisted vaginal hysterectomy for large uteri between 280 and 700 g: a randomized controlled trial. To compare surgical outcomes, postoperative complications and costs between vaginal hysterectomy and laparoscopically assisted vaginal hysterectomy in cases of large uteri.Prospective randomized controlled trial done at Ain Shams University Maternity Hospital, where 50 patients were recruited and divided into two equal groups (each 25 patients). First (...) group underwent vaginal hysterectomy, and the second underwent laparoscopically assisted vaginal hysterectomy.Patient characteristics were similar in both groups. As for surgical outcomes, estimated intraoperative blood loss (P = 0.90), operative time (P = 0.48), preoperative hemoglobin (P = 0.09), postoperative hemoglobin (P = 0.42), and operative complications (P = 1.0) did not differ between the two groups. The hospital costs (converted from Egyptian pound to U.S. dollars) were significantly

2018 Archives of gynecology and obstetrics Controlled trial quality: uncertain

31. Efficacy and safety outcomes of robotic radical hysterectomy in Chinese older women with cervical cancer compared with laparoscopic radical hysterectomy. (PubMed)

Efficacy and safety outcomes of robotic radical hysterectomy in Chinese older women with cervical cancer compared with laparoscopic radical hysterectomy. Recently, as a complex integrating a number of modern high-tech means, robotic surgery system is a well-deserved revolutionary tool in globally minimally invasive surgical field. For the first time in China, the objective of this study was to evaluate the efficacy and safety outcomes of robotic radical hysterectomy (RRH) in Chinese older women (...) with cervical cancer compared with laparoscopic radical hysterectomy (LRH).In this prospective, randomized and double-blinded study, 60 Chinese older women with cervical cancer were evenly divided to accept the RRH or LRH. Follow-up period lasted for 24 months.Median age for the entire cohort was 65 (range: 61-69) years. There was no difference in International Federation of Gynecology and Obstetrics (FIGO) stages and cell types between two groups (p > 0.05 for all). Uterine size, tumor size, vaginal length

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2018 BMC Women's Health Controlled trial quality: uncertain

32. Vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis of randomized controlled trials

Vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis of randomized controlled trials Vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis of randomized controlled trials Vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis of randomized controlled trials Gendy R, Walsh CA, Walsh SR, Karantanis E CRD summary This review concluded that total laparoscopic hysterectomy may (...) offer benefits over vaginal hysterectomy for benign disease. This conclusion was appropriately cautious. The paucity of data (acknowledged by the authors), limited quality of the included trials and incomplete reporting of review process should be borne in mind when interpreting the pooled results. Authors' objectives To compare the perioperative and postoperative outcomes associated with vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease. Searching PubMed, SCOPUS

2012 DARE.

33. Impact of different intraoperative CO2 pressure levels (8 and 15 mmHg) during laparoscopic hysterectomy performed due to benign uterine pathologies on postoperative pain and arterial pCO2 : a prospective randomised controlled clinical trial

Impact of different intraoperative CO2 pressure levels (8 and 15 mmHg) during laparoscopic hysterectomy performed due to benign uterine pathologies on postoperative pain and arterial pCO2 : a prospective randomised controlled clinical trial To compare the effects of two different intraoperative CO2 pressures (8 and 15 mmHg) during laparoscopic hysterectomy for benign uterine pathologies in terms of postoperative abdominal and shoulder pain, laparoscopy-mediated vegetative alterations, pain (...) medication requirement, arterial CO2 pressure (pCO2 ), surgical parameters, and safety.Prospective randomised controlled study.German university hospital.Female patients undergoing laparoscopic hysterectomy for benign uterine pathologies.Patients were randomised to a standard pressure (SP; 15 mmHg, control) or low-pressure (LP; 8 mmHg, experimental) group.Primary outcomes were postoperative abdominal and shoulder pain intensities, measured via numeric rating scale (NRS) and vegetative parameters (fatigue

2019 EvidenceUpdates

34. Postoperative Bladder Filling After Outpatient Laparoscopic Hysterectomy and Time to Discharge: A Randomized Controlled Trial

Postoperative Bladder Filling After Outpatient Laparoscopic Hysterectomy and Time to Discharge: A Randomized Controlled Trial To determine whether backfilling the bladder postoperatively will reduce time to discharge in patients undergoing outpatient laparoscopic hysterectomy.In a single-blind, randomized, controlled trial among women undergoing outpatient laparoscopic hysterectomy, patients were randomly assigned to a backfill-assisted void trial or a trial of spontaneous voiding. The primary

2019 EvidenceUpdates

35. Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations

Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations Laparoscopic hysterectomy is increasingly performed because it is associated with less postoperative pain and earlier recovery as compared with open abdominal hysterectomy. The aim of this systematic review was to evaluate the available literature regarding the management of pain after laparoscopic hysterectomy.Randomized controlled trials evaluating postoperative pain after (...) laparoscopic hysterectomy published between January 1996 and May 2018 were retrieved, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, from the EMBASE and MEDLINE databases and the Cochrane Register of Controlled Trials. Efficacy and adverse effects of analgesic techniques were assessed.Of the 281 studies initially identified, 56 were included. Of these, 31 assessed analgesic or anesthetic interventions and 25 assessed surgical interventions. Acetaminophen

2019 EvidenceUpdates

36. Analgesic Efficacy and Safety of Intravenous Meloxicam in Subjects With Moderate-to-Severe Pain After Open Abdominal Hysterectomy: A Phase 2 Randomized Clinical Trial

Analgesic Efficacy and Safety of Intravenous Meloxicam in Subjects With Moderate-to-Severe Pain After Open Abdominal Hysterectomy: A Phase 2 Randomized Clinical Trial An intravenous (IV) formulation of meloxicam was developed for moderate-to-severe pain management. This study evaluated the safety and efficacy of meloxicam IV after open abdominal hysterectomy. Meloxicam IV is an investigational product not yet approved by the US Food and Drug Administration.Women (N = 486) with moderate (...) -to-severe pain after open abdominal hysterectomy were enrolled in this multicenter, randomized, double-blind, placebo- and active-controlled trial. Subjects were randomized to receive a single dose of meloxicam IV (5-60 mg), placebo, or morphine (0.15 mg/kg) in ≤6 hours after morphine dosing on postoperative day 1 and were evaluated for 24 hours. Rescue morphine (≈0.15 mg/kg IV) was available if needed for pain not relieved by the study medication. In an open-label extension (N = 295), meloxicam IV

2019 EvidenceUpdates

37. Effect of postoperative partial bladder filling after minimally invasive hysterectomy on postanesthesia care unit discharge and cost: a single-blinded, randomized controlled trial

Effect of postoperative partial bladder filling after minimally invasive hysterectomy on postanesthesia care unit discharge and cost: a single-blinded, randomized controlled trial Hysterectomy is one of the most common surgical procedures performed each year with substantial related health care costs. This trial studied the effect of postoperative bladder backfilling to submicturition level in the operating room and its effect on early postoperative patient care and related cost.The objective (...) of the study was to compare the effect of bladder backfilling on early postoperative patient care and related cost.This was a randomized, single-blinded, controlled trial conducted between April 2016 and February 2017 at a single urban university hospital providing tertiary care for minimally invasive gynecologic surgery. Ninety-one patients undergoing straight-stick laparoscopic and robot-assisted hysterectomy by minimally invasive gynecologic surgeons for benign indications were recruited. The bladder

2019 EvidenceUpdates

38. Erector spinae plane block for postoperative analgesia in patients undergoing total abdominal hysterectomy: a randomized controlled study original study

Erector spinae plane block for postoperative analgesia in patients undergoing total abdominal hysterectomy: a randomized controlled study original study Background: Abdominal hysterectomy is associated with marked postoperative pain and morbidity, but effective postoperative analgesia provides early recovery and ambulation. Aim: We intended to assess the efficacy of bilateral erector spinae plane block (ESPB) on postoperative analgesia in females undergoing abdominal hysterectomy under general (...) anesthesia. Settings and Design: The design was a prospective, randomized, controlled, single-blind clinical study. Patients and Methods: Sixty patients with American Society of Anesthesiologists (ASA) physical status classes Ι to ΙΙΙ were scheduled for elective abdominal hysterectomy under general anesthesia, patients were randomly allocated into two equal groups. ESPB patients received ultrasound-guided ESPB at T9 vertebrae level with 20 ml bupivacaine 0.5%. Control group patients did not receive

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2019 EvidenceUpdates

39. Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial

Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial To evaluate if immediate catheter removal (ICR) after laparoscopic hysterectomy is associated with similar retention outcomes compared with delayed removal (DCR).Non-inferiority randomised controlled trial.Women undergoing laparoscopic hysterectomy in six hospitals in the Netherlands.Women were randomised to ICR or DCR (between 18 and 24 hours after surgery).The inability to void (...) with voiding difficulties could void spontaneously within 9 hours after laparoscopic hysterectomy. It is therefore questionable if all observed urinary retention cases were clinically relevant. As a result, the clinical advantages of ICR may still outweigh the risk of bladder retention and it should therefore be considered after uncomplicated laparoscopic hysterectomy.The advantages of immediate catheter removal after laparoscopic hysterectomy seem to outweigh the risk of bladder retention.© 2018

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2019 EvidenceUpdates

40. Sacrospinous hysteropexy versus vaginal hysterectomy with uterosacral ligament suspension in women with uterine prolapse stage 2 or higher: observational follow-up of a multicentre randomised trial. (PubMed)

Sacrospinous hysteropexy versus vaginal hysterectomy with uterosacral ligament suspension in women with uterine prolapse stage 2 or higher: observational follow-up of a multicentre randomised trial. To evaluate the effectiveness and success of uterus preserving sacrospinous hysteropexy as an alternative to vaginal hysterectomy with uterosacral ligament suspension in the surgical treatment of uterine prolapse five years after surgery.Observational follow-up of SAVE U (sacrospinous fixation (...) versus vaginal hysterectomy in treatment of uterine prolapse ≥2) randomised controlled trial.Four non-university teaching hospitals, the Netherlands.204 of 208 healthy women in the initial trial (2009-12) with uterine prolapse stage 2 or higher requiring surgery and no history of pelvic floor surgery who had been randomised to sacrospinous hysteropexy or vaginal hysterectomy with uterosacral ligament suspension. The women were followed annually for five years after surgery. This extended trial

2019 BMJ

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