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Hysterectomy

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61. The 95% effective dose of nalbuphine in patient-controlled intravenous analgesia for patients undergoing laparoscopic total hysterectomy compared to equivalent sufentanil. Full Text available with Trip Pro

The 95% effective dose of nalbuphine in patient-controlled intravenous analgesia for patients undergoing laparoscopic total hysterectomy compared to equivalent sufentanil. To evaluate the 95% effective dose of nalbuphine in patient-controlled intravenous analgesia (PCIA) by the sequential method and compare the analgesia efficacy with the equivalent dose of sufentanil on patients undergoing laparoscopic total hysterectomy.In the first part, we defined a successful analgesia as the highest VAS (...) ≤3 in 24 hours postoperatively. On the contrary, a failed analgesia was the highest VAS>3. According to the last patient's outcome, the next patients would be given an increase or decreased dose grade. This process ended up with 9 cross-over points. In the second part, 60 patients undergoing laparoscopic total hysterectomy were selected. They were randomly divided into 2 groups (n = 30 each group): receiving sufentanil 1.78 μg/kg (group S) and nalbuphine 1.78 mg/kg (group N). PCIA pump was given

2020 Medicine

62. Risk of complication at the time of laparoscopic hysterectomy: a prediction model built from the National Surgical Quality Improvement Program database. (Abstract)

Risk of complication at the time of laparoscopic hysterectomy: a prediction model built from the National Surgical Quality Improvement Program database. Although laparoscopic hysterectomy is well established as a favorable mode of hysterectomy owing to decreased perioperative complications, there is still room for improvement in quality of care. Previous studies have described laparoscopic hysterectomy risk, but there is currently no tool for predicting risk of complication at the time (...) of laparoscopic hysterectomy.This study aimed to create a prediction model for complications at the time of laparoscopic hysterectomy for benign conditions.This is a retrospective cohort study that included patients who underwent laparoscopic hysterectomy for benign indications between 2014 and 2017 in US hospitals contributing to the American College of Surgeons - National Surgical Quality Improvement Program database. Data about patient baseline characteristics, perioperative complications (intraoperative

2020 American Journal of Obstetrics and Gynecology

63. Hysterectomy with and without oophorectomy and all-cause and cause-specific mortality. (Abstract)

Hysterectomy with and without oophorectomy and all-cause and cause-specific mortality. Hysterectomy is one of the most commonly performed gynecological surgeries, with an estimated 30% of women in Australia undergoing the procedure by age 70. In the USA, about 45% of women have a hysterectomy in their lifetime. Some studies have suggested this procedure increases the risk of premature mortality. With many women making the decision to have a hysterectomy for a benign indication each year (...) , additional research is needed to clarify whether there are long-term health consequences of hysterectomy.Our aim was to examine the association between hysterectomy for benign indications, with or without removal of the ovaries, and cause-specific and all-cause mortality.Our cohort of 666,588 women comprised the female population of Western Australia with linked hospital and health records from 1970 to 2015. We used Cox regression models to assess the association between hysterectomy and all-cause

2020 American Journal of Obstetrics and Gynecology

64. The rapid adoption of opportunistic salpingectomy at the time of hysterectomy for benign gynecologic disease in the United States. (Abstract)

The rapid adoption of opportunistic salpingectomy at the time of hysterectomy for benign gynecologic disease in the United States. Mounting evidence for the role of distal fallopian tubes in the pathogenesis of epithelial ovarian cancer has led to opportunistic salpingectomy being increasingly performed at the time of benign gynecologic surgery. Opportunistic salpingectomy has now been recommended as best practice in the United States to reduce future risk of ovarian cancer even in low-risk (...) women. Preliminary analyses have suggested that performance of opportunistic salpingectomy is increasing.To examine trends in opportunistic salpingectomy in women undergoing benign hysterectomy and to determine how the publication of the tubal hypothesis in 2010 may have contributed to these trends.This is a population-based, retrospective, observational study examining the National Inpatient Sample between January 2001 and September 2015. Women younger than 50 years who underwent inpatient

2020 American Journal of Obstetrics and Gynecology

65. Use of bowel preparation does not reduce postoperative infectious morbidity following minimally invasive or open hysterectomies. (Abstract)

Use of bowel preparation does not reduce postoperative infectious morbidity following minimally invasive or open hysterectomies. Literature on the use of bowel preparation in gynecologic surgery is scarce and limited to minimally invasive gynecologic surgery. The decision on the use of bowel preparation before benign or malignant hysterectomies is mostly driven by extrapolating data from the colorectal literature.Bowel preparation is a controversial element within enhanced recovery protocols (...) , and literature investigating its efficacy in gynecologic surgery is scarce. Our aim was to determine if mechanical bowel preparation alone, oral antibiotics alone, or a combination are associated with decreased rates of surgical site infections or anastomotic leaks compared to no bowel preparation following benign or malignant hysterectomy.We identified women who underwent hysterectomy between January 2006 and July 2017 using OptumLabs, a large US commercial health plan database. Inverse propensity score

2020 American Journal of Obstetrics and Gynecology

66. Robotic natural orifice transluminal endoscopic surgery (NOTES) hysterectomy as a scarless and gasless surgery. (Abstract)

Robotic natural orifice transluminal endoscopic surgery (NOTES) hysterectomy as a scarless and gasless surgery. To report a new surgical technique for hysterectomy using robotic natural orifice transluminal endoscopic surgery (NOTES) as a scarless and gasless procedure.Thirteen consecutive patients with benign uterine disease underwent robotic NOTES hysterectomy at Eulji University Hospital between February 2017 and May 2018.Due to the presence of pelvic adhesions, one of these patients (...) underwent hybrid robotic NOTES hysterectomy with the assistance of isobaric single port laparoscopy; however, there was no conversion to another hysterectomy type such as conventional laparoscopy, laparotomy, or traditional multiport robotic surgery. Median uterine weight was 290 g (range 115-892 g). Median docking and console times were 15 min (range 5-25 min) and 135 min (range 92-215 min), respectively. Mean change in hemoglobin on the first postoperative day was 0.67 ± 0.7 g/dL. Median EBL was 50 mL

2020 Surgical endoscopy

67. Impact of prior hysterectomy on surgical outcomes for laparoscopic adnexal surgery. (Abstract)

Impact of prior hysterectomy on surgical outcomes for laparoscopic adnexal surgery. Adnexal surgery is believed to be more complex in patients with prior hysterectomy; however, there is little data regarding surgical outcomes. Understanding of individualized risks improves counseling, informed consent, and preoperative planning.We performed a retrospective cohort study with a control group; we evaluated 744 patients undergoing laparoscopic adnexal surgery at an academic tertiary care center (...) from 2011 to 2015. Comparisons were made using Chi square, Fisher's exact, or Wilcoxon-rank sum tests. We used log-binomial regression to calculate risk ratio and 95% confidence interval.Patients with prior hysterectomy were more likely to have intraoperative or postoperative complications at the time of laparoscopic adnexal surgery when compared to patients without prior hysterectomy [17.7% vs. 10.2%, p = 0.02, risk ratio (RR) 1.7, 95% confidence interval (CI) 1.1-2.7]. Patients with prior

2020 Surgical endoscopy

68. Breast cancer risk after hysterectomy with and without salpingo-oophorectomy for benign indications. (Abstract)

Breast cancer risk after hysterectomy with and without salpingo-oophorectomy for benign indications. Breast cancer risk has been extensively studied in women with genetic predisposition, i.e. BRCA1/2. Though there are guidelines for performing bilateral salpingo-oophorectomies in individuals with specific genetic risks, oophorectomies are also performed in many average-risk women. The risk of breast cancer in average risk women who undergo hysterectomy with bilateral salpingo-oophorectomy (...) for benign indications is less clear.We aim to estimate breast cancer risk following hysterectomy with and without concomitant bilateral salpingo-oophorectomy for benign indications.From 2001 to 2015, women aged 18 and older from Kaiser Permanente Northern California who underwent hysterectomy alone and hysterectomy with bilateral salpingo-oophorectomy were identified using ICD-9 procedure and CPT codes. Women with a BRCA mutation and prior history of breast or gynecologic cancer were excluded

2020 American Journal of Obstetrics and Gynecology

69. Workplace absenteeism amongst patients undergoing open vs. robotic radical prostatectomy, hysterectomy, and partial colectomy. (Abstract)

Workplace absenteeism amongst patients undergoing open vs. robotic radical prostatectomy, hysterectomy, and partial colectomy. There is controversy regarding the widespread uptake of robotic surgery across several surgical disciplines. While it has been shown to confer clinical benefits such as decreased blood loss and shorter hospital stays, some argue that the benefits of this technology do not outweigh its high cost. We performed a retrospective insurance-based analysis to investigate how (...) undergoing robotic surgery, compared to open surgery, may impact the time in which an employed individual returns to work after undergoing major surgery.We identified a cohort of US adults with employer-sponsored insurance using claims data from the MarketScan database who underwent either open or robotic radical prostatectomy, hysterectomy/myomectomy, and partial colectomy from 2012 to 2016. We performed multiple regression models incorporating propensity scores to assess the effect of robotic vs. open

2020 Surgical endoscopy

70. Minimizing surgical blood loss at cesarean hysterectomy for placenta previa with evidence of placenta increta or placenta percreta: the state of play in 2020. (Abstract)

Minimizing surgical blood loss at cesarean hysterectomy for placenta previa with evidence of placenta increta or placenta percreta: the state of play in 2020. The evolution of multidisciplinary team-based care for women with placenta accreta spectrum disorder has delivered stepwise improvements in clinical outcomes. Central to this overall goal is the ability to limit blood loss at surgery. Placement of inflatable balloons within the pelvic arteries, most commonly in the anterior divisions (...) an infrarenal aortic balloon, with both impressively low rates of blood loss and an ability to conserve the uterus by resecting the placenta with the affected portion of the uterine wall. We review these literature developments in the context of safely performing elective cesarean hysterectomy for placenta previa-percreta, the most severe placenta accreta spectrum disorder.Copyright © 2020 Elsevier Inc. All rights reserved.

2020 American Journal of Obstetrics and Gynecology

71. Hypervolemia does not cause degradation of the endothelial glycocalyx layer during open hysterectomy performed under sevoflurane or propofol anesthesia. (Abstract)

Hypervolemia does not cause degradation of the endothelial glycocalyx layer during open hysterectomy performed under sevoflurane or propofol anesthesia. Fluid-induced hypervolemia may stimulate the release of natriuretic peptides and cause degradation (shedding) of the endothelial glycocalyx layer. Sevoflurane is believed to protect the glycocalyx, but the importance of using sevoflurane to prevent shedding during routine surgery is unclear.The plasma concentrations of brain natriuretic peptide (...) and two biomarkers of glycocalyx shedding, syndecan-1, and heparan sulfate, were measured in 26 patients randomized to receive general anesthesia with sevoflurane or propofol during open abdominal hysterectomy. The fluid therapy consisted of 25 mL/kg (approximately 2 L) of Ringer´s lactate over 30 minutes. Blood hemoglobin and plasma albumin were used to indicate plasma volume expansion and capillary leakage.The plasma concentrations of brain natriuretic peptide and shedding products showed low levels

2020 Acta Anaesthesiologica Scandinavica

72. [Efficacy and safety laparoscopic hysterectomy and lymphadenectomy in endometrial cancer (update)]

[Efficacy and safety laparoscopic hysterectomy and lymphadenectomy in endometrial cancer (update)] Seguridad y eficacia de la linfadenectomía laparoscópica en el cáncer ginecológico (actualización) [Efficacy and safety laparoscopic hysterectomy and lymphadenectomy in endometrial cancer (update)] Seguridad y eficacia de la linfadenectomía laparoscópica en el cáncer ginecológico (actualización) [Efficacy and safety laparoscopic hysterectomy and lymphadenectomy in endometrial cancer (update)] Zoni (...) AC, Nováková V Citation Zoni AC, Nováková V. Seguridad y eficacia de la linfadenectomía laparoscópica en el cáncer ginecológico (actualización) . [Efficacy and safety laparoscopic hysterectomy and lymphadenectomy in endometrial cancer (update)] Unidad de Evaluacion de Tecnologias Sanitarias (UETS). Informes de Evaluación de Tecnologías Sanitarias. 2014 Authors' objectives To assess the effectiveness and safety of the laparoscopic hysterectomy and lymphadenectomy in endometrial cancer and compared

2015 Health Technology Assessment (HTA) Database.

73. Reduced length of stay and hospitalization costs among inpatient hysterectomy patients with postoperative pain management including IV versus oral acetaminophen. Full Text available with Trip Pro

Reduced length of stay and hospitalization costs among inpatient hysterectomy patients with postoperative pain management including IV versus oral acetaminophen. To compare the outcomes of hysterectomy patients who received standard pain management including IV acetaminophen (IV APAP) versus oral APAP.We performed a retrospective analysis of the Premier Database (January 2012 to September 2015) comparing hysterectomy patients who received postoperative pain management including IV APAP to those (...) , and hospital characteristics.We identified 22,828 hysterectomy patients including 14,811 (65%) who had received IV APAP. Study subjects averaged 50 and 52 years of age, respectively in the IV APAP and oral APAP cohorts and were predominantly non-Hispanic Caucasians (≥60% in both cohorts). Instrumental variable models found IV APAP associated with 0.8 days shorter hospitalization (95% CI: -0.92 to -0.68, p<0.0001) and $2,449 lower hospitalization costs (95% CI: -$2,902 to -$1,996, p<0.0001). Average daily

2018 PLoS ONE

74. Development of an objective assessment tool for total laparoscopic hysterectomy: A Delphi method among experts and evaluation on a virtual reality simulator. Full Text available with Trip Pro

Development of an objective assessment tool for total laparoscopic hysterectomy: A Delphi method among experts and evaluation on a virtual reality simulator. Total Laparoscopic hysterectomy (LH) requires an advanced level of operative skills and training. The aim of this study was to develop an objective scale specific for the assessment of technical skills for LH (H-OSATS) and to demonstrate feasibility of use and validity in a virtual reality setting.The scale was developed using

2018 PLoS ONE

75. Perimortem cesarean delivery and subsequent emergency hysterectomy: new strategy for maternal cardiac arrest Full Text available with Trip Pro

Perimortem cesarean delivery and subsequent emergency hysterectomy: new strategy for maternal cardiac arrest Perimortem cesarean delivery (PMCD) is the only way to resuscitate pregnant women in cardiac arrest, and has been found to increase maternal resuscitation rate by increasing circulating plasma volume. However, many obstetricians have not experienced a case of PMCD, as situations requiring it are rare. We report our strategy for cases of maternal cardiac arrest, on the basis of a review (...) of published work, and present two case reports from our medical center.In case 1, PMCD led to death by massive bleeding. In case 2, PMCD and hysterectomy were carried out after the introduction of venoarterial extracorporeal membrane oxygenation, and both mother and baby survived.We find that rapid hysterectomy as a damage control surgery following PMCD can be life-saving for both mother and baby.

2017 Acute medicine & surgery

76. Frequency and causes of emergency hysterectomy along with vaginal delivery and caesarean section in Hamadan, Iran Full Text available with Trip Pro

Frequency and causes of emergency hysterectomy along with vaginal delivery and caesarean section in Hamadan, Iran Emergency hysterectomy (peripartum) is a high-risk surgery that almost always is done in the treatment or prevention of severe and life-threatening bleeding that occurs after vaginal delivery or caesarean.To compare the frequency and causes of emergency hysterectomy along with the vaginal delivery and caesarean section (CS).The cross-sectional research was conducted on patients who (...) underwent a peripartum hysterectomy from 2005 to 2015 at Fatemieh Hospital in Hamadan City, Iran. Data collection tools included a questionnaire about demographic features and factors associated with hysterectomy surgery. Data were analyzed using SPSS version 21 and by descriptive statistics, chi-square, paired t-test, and one-way analysis of variance (ANOVA).The mean age of women was 33.4±5.09 years. In recent years, 37 cases of hysterectomy were reported, with the peak occurring in 2015. The highest

2017 Electronic physician

77. Relationship between hysterectomy and severity of female stress urinary incontinence Full Text available with Trip Pro

Relationship between hysterectomy and severity of female stress urinary incontinence Stress Urinary Incontinence (SUI) is one of the most reported health dilemmas of women suffering from lower urinary tract symptoms.To determine the relation between hysterectomy and severity of female SUI using Valsalva Leak Point Pressure (VLPP).This case-control study was conducted at a public urology clinic in Tehran in 2015. The study population was all female with SUI complaints who visited the clinic (...) during 2015. We compared Valsalva leak point pressure in two groups of female SUI patients with and without hysterectomy history. The inclusion criteria were: not taking any alpha-blocker or anti-cholinergic medicines two weeks prior to the urodynamic test as well as no history of pelvic surgery or cesarean delivery in their lifetime. All qualified patients were invited to participate in the study randomly, and among them, 120 qualified patients agreed to participate by filling out the informed

2017 Electronic physician

78. Comparison of vaginal hysterectomy with laparoscopic hysterectomy: a meta-analysis of randomized controlled trials

Comparison of vaginal hysterectomy with laparoscopic hysterectomy: a meta-analysis of randomized controlled trials Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence

2018 PROSPERO

79. Robot-assisted laparoscopic hysterectomy vs traditional laparoscopic hysterectomy: five metaanalyses

Robot-assisted laparoscopic hysterectomy vs traditional laparoscopic hysterectomy: five metaanalyses Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2011 DARE.

80. Laparoscopic-assisted vaginal hysterectomy vs abdominal hysterectomy for benign disease: a meta-analysis of randomized controlled trials

Laparoscopic-assisted vaginal hysterectomy vs abdominal hysterectomy for benign disease: a meta-analysis of randomized controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2011 DARE.

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