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Hysterectomy

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101. Total hysterectomy versus uterine evacuation for preventing post-molar gestational trophoblastic neoplasia in patients who are at least 40 years old: a systematic review and meta-analysis. (PubMed)

Total hysterectomy versus uterine evacuation for preventing post-molar gestational trophoblastic neoplasia in patients who are at least 40 years old: a systematic review and meta-analysis. The clinical value of total hysterectomy for patients with hydatidiform mole (HM) being at least 40 years old remains highly controversial. Since the practice of hysterectomy has been applied globally for decades, there is an urgent need to perform a systematic review to assess its risks and benefits.Six (...) electronic databases, including four English databases and one Chinese database, were searched from the inception of each database till October 6th 2017. Studies were included if they: 1) were human studies, 2) explicitly indicated exposure to hysterectomy, 3) explicitly indicated control to uterine evacuation, 4) explicitly indicated the participants were older patients with HM being at least 40 years in age, 5) compared the outcome of interest as the incidence of post-molar GTN. Two authors

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2019 BMC Cancer

102. Unexpected malignant uterine pathology: Incidence, characteristics and outcome in a large single-center series of hysterectomies for presumed benign uterine disease. (PubMed)

Unexpected malignant uterine pathology: Incidence, characteristics and outcome in a large single-center series of hysterectomies for presumed benign uterine disease. Hysterectomy is a frequently used therapeutic option for benign gynecological conditions. The purpose of this study was to investigate the incidence and characteristics of unforeseen malignant pathologies of the uterine corpus in a large population-based, single center cohort.Patients who underwent hysterectomy for presumed benign (...) conditions between 2003 and 2016 were identified. In cases of unexpected malignancies of the uterine corpus (UUM), available tissue samples were collected and a specialized gynecopathological review was performed.A total of 10,756 patients underwent hysterectomy for benign indications. After chart and gynecopathological review, 45/10,756 (0.42%) cases of unexpected uterine malignancies were confirmed. 33/45 (73.3%) were endometrial carcinomas (UEC) and 12/45 (26.7%) were uterine sarcomas (UUS). 27/33

2019 Gynecologic Oncology

103. Long-term Follow-up After Endometrial Ablation in Finland: Cancer Risks and Later Hysterectomies

Long-term Follow-up After Endometrial Ablation in Finland: Cancer Risks and Later Hysterectomies To study the risk of endometrial cancer and breast cancer and the hysterectomy rate after endometrial ablation.In this retrospective cohort study, records of all women with endometrial ablation at ages 30-49 years in Finland (1997-2014) were extracted from the Hospital Discharge Register and linked to the Cancer Registry and Finnish Central Population Register. The primary outcome was cancer (...) incidences in the endometrial ablation cohort compared with those in the background population of the same age. Secondarily, the postablation hysterectomy rate was compared with that of a control cohort of similar-aged women extracted from the Finnish Central Population Register. Multivariate regression models with adjustment for age, parity, number of cesarean deliveries, history of sterilization, and the duration of follow-up were evaluated as risk factors for postablation hysterectomy.In total, 154

2017 EvidenceUpdates

104. Development of an objective assessment tool for total laparoscopic hysterectomy: A Delphi method among experts and evaluation on a virtual reality simulator. (PubMed)

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

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2018 PLoS ONE

105. Removal of all ovarian tissue versus conserving ovarian tissue at time of hysterectomy in premenopausal patients with benign disease: study using routine data and data linkage. (PubMed)

Removal of all ovarian tissue versus conserving ovarian tissue at time of hysterectomy in premenopausal patients with benign disease: study using routine data and data linkage.  To conduct a nationwide study of associations between removal of all ovarian tissue versus conservation of at least one ovary at the time of hysterectomy and important health outcomes (ischaemic heart disease, cancer, and all cause mortality). Retrospective analysis of the English Hospital Episode Statistics database (...) linked to national registers of deprivation indices and of deaths. 113 679 patients aged 35-45 who had had a hysterectomy for benign conditions between April 2004 and March 2014. Bilateral ovarian removal versus no removal or unilateral ovarian removal (ovarian conservation). Hospital admissions for ischaemic heart disease, cancer, or attempted suicide; deaths, overall and from heart disease, cancer, or suicide. Statistical adjustments were made using Cox regression and propensity score matching

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2017 BMJ

106. Vaginal or laparoscopic hysterectomy: do peri-operative outcomes differ? A propensity score matched analysis. (PubMed)

Vaginal or laparoscopic hysterectomy: do peri-operative outcomes differ? A propensity score matched analysis. There are assertions that vaginal mode may be the preferred approach of minimally invasive hysterectomy, yet rates of laparoscopic hysterectomy (LH) continue to rise while vaginal hysterectomy (VH) rate remains relatively unchanged. The aim of this study is to compare the perioperative outcomes of LH vs VH.We identified women who underwent either LH or VH for benign indications between (...) favorable perioperative outcomes; however, LH is associated with lower blood loss and a shorter hospital stay. The results support the trend toward increasing rates of laparoscopic approach to hysterectomy when appropriate.© 2019 Nordic Federation of Societies of Obstetrics and Gynecology.

2019 Acta Obstetricia et Gynecologica Scandinavica

107. Opioid use after laparoscopic hysterectomy: prescriptions, patient use, and a predictive calculator. (PubMed)

Opioid use after laparoscopic hysterectomy: prescriptions, patient use, and a predictive calculator. In the setting of America's opioid epidemic, judicious postoperative opioid prescribing is important. Gynecologists lack standard guidelines about postoperative opioid prescriptions.The objectives of the study were to describe opioid prescribing practices by a group of minimally invasive gynecologic surgeons, to measure postoperative opioid use after minimally invasive hysterectomy (...) , and to identify preoperative factors that could predict whether a patient will be a low or high postoperative opioid user.This was a prospective survey-based study including 125 women undergoing laparoscopic hysterectomy for benign indications at 2 community teaching hospitals. Patients were preoperatively surveyed about demographics, past medical history, and current and expected pain scores and were screened for anxiety, depression, and pain catastrophizing. At 1 and 2 weeks after surgery, patients were

2019 American Journal of Obstetrics and Gynecology

108. Prevalence, Characteristics, and Risk Factors of Occult Uterine Cancer in Presumed Benign Hysterectomy. (PubMed)

Prevalence, Characteristics, and Risk Factors of Occult Uterine Cancer in Presumed Benign Hysterectomy. Occult uterine cancer at the time of benign hysterectomy poses unique challenges in patient care. There is large variability and uncertainty in estimated risk of occult uterine cancer in the literature and prior research often did not differentiate/include all subtypes.To thoroughly examine the prevalence of occult uterine cancer in a large population-based sample of women undergoing (...) hysterectomy for presumed benign indications and to identify associated risk factors.Using the New York Statewide Planning and Research Cooperative System database, we identified 229,536 adult women who underwent an inpatient or outpatient hysterectomy for benign indications in 10/1/2003-12/31/2013 at civilian hospitals and ambulatory surgery centers throughout the State. Diagnosis of corpus uteri cancer within 28 days after the index hysterectomy was determined using linked state cancer registry data. We

2019 American Journal of Obstetrics and Gynecology

109. Comparative outcomes between robotic and abdominal radical hysterectomy for IB1 cervical cancer: Results from a single high volume institution. (PubMed)

Comparative outcomes between robotic and abdominal radical hysterectomy for IB1 cervical cancer: Results from a single high volume institution. To compare the perioperative morbidity and survival between abdominal radical hysterectomy (ARH) and robotic radical hysterectomy (RRH).A retrospective cohort of patients undergoing radical hysterectomy for cervical cancer from 2010 to 2016 was identified. Patients with stage IB1 cervical cancer were included and were grouped by ARH vs. RRH. Tumor

2019 Gynecologic Oncology

110. Lessons learnt from anonymized review of cases of peripartum hysterectomy by international experts: a qualitative pilot study. (PubMed)

Lessons learnt from anonymized review of cases of peripartum hysterectomy by international experts: a qualitative pilot study. Severe obstetric complications are not extensively studied and individual cases are used too little and inappropriately in quality improvement activities, due to limited numbers and prioritization of quantitative research. Nordic and European experts performed a qualitative pilot study using anonymized cases of peripartum hysterectomy. It was feasible to anonymize (...) narratives and we learned lessons in the form of themes for improved clinical care and future research. Therefore, we plan a Nordic anonymized review of the care of women who have undergone peripartum hysterectomy based on narratives. The qualitative outcomes of clinically relevant themes for quality improvement and research will add value to the quantitative analyses from the Nordic medical birth registries. In the longer term, we believe that qualitative audits should be essential part of the process

2019 Acta Obstetricia et Gynecologica Scandinavica

111. Effect of modified laparoscopic hysterectomy on pelvic floor function: A retrospective observational study. (PubMed)

Effect of modified laparoscopic hysterectomy on pelvic floor function: A retrospective observational study. Hysterectomy is a potential risk factor for subsequent surgery for pelvic organ prolapse, especially when the prolapse exists before hysterectomy. Women without prolapse before hysterectomy may also experience prolapse after hysterectomy. This study aimed to describe a surgical modification of laparoscopic colposuspension with round ligaments after hysterectomy in women without (...) preexisting genital prolapse and to evaluate the initial surgical results in these patients.We reviewed data of 54 patients who underwent laparoscopic hysterectomy with colposuspension with unilateral or bilateral round ligaments after hysterectomy at Chia-Yi Chang Gung Memorial Hospital from July 2012 to March 2015. Vaginal length was measured before and after colposuspension after complete hysterectomy. Preoperative characteristics of the patients, perioperative quality, postoperative outcomes

2019 Medicine

112. Local news hype of robotic surgery doesn’t match many hysterectomy patients’ experiences

Local news hype of robotic surgery doesn’t match many hysterectomy patients’ experiences Local news hype of robotic surgery doesn't match many hysterectomy patients' experiences - HealthNewsReview.org Note to our followers: Our nearly 13-year run of daily publication of new content on HealthNewsReview.org came to a close at the end of 2018. Publisher Gary Schwitzer and other contributors may post new articles periodically. But all of the 6,000+ articles we have published contain lessons to help (...) you improve your critical thinking about health care interventions. And those will be still be alive on the site for a couple of years. 6093 Posts Menu July 17, 2018 Local news hype of robotic surgery doesn’t match many hysterectomy patients’ experiences Posted By Categories , , Tags Gary Schwitzer is the founder and publisher of HealthNewsReview.org. He has about the proliferation of robotic surgery systems. He tweets as . to read more stories about real people harmed by misleading messages

2018 HealthNewsReview

113. Conization pathologic features as a predictor of intermediate and high risk features on radical hysterectomy specimens in early stage cervical cancer. (PubMed)

Conization pathologic features as a predictor of intermediate and high risk features on radical hysterectomy specimens in early stage cervical cancer. The impact of pathologic features of a cone biopsy on the management of women with early stage cervical cancer is understudied. Our objective was to evaluate the additive value of pathologic features of a cone biopsy toward identifying patients with high risk tumors for which adjuvant therapy may be indicated.Patients with early stage cervical (...) cancer undergoing a conization followed by radical hysterectomy from 1995 to 2016 were retrospectively identified. Clinical and pathologic data were abstracted from patient medical records.A total of 115 patients were identified. Based on final pathology, 70.5% were low risk, 10.4% intermediate risk, and 19.1% were high risk. The additive pathologic features of the conization specimen would have reclassified five patients from low into the intermediate risk group. Though depth of invasion did

2019 Gynecologic Oncology

114. Hysterectomy: All obstetrician-gynecologists should learn to perform it. (PubMed)

Hysterectomy: All obstetrician-gynecologists should learn to perform it. 30661252 2019 02 04 1600-0412 2019 Jan 20 Acta obstetricia et gynecologica Scandinavica Acta Obstet Gynecol Scand Hysterectomy: All obstetrician-gynecologists should learn to perform it. 10.1111/aogs.13539 Matsubara Shigeki S https://orcid.org/0000-0003-4378-221X Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan. Takahashi Hironori H Department of Obstetrics and Gynecology, Jichi Medical

2019 Acta Obstetricia et Gynecologica Scandinavica

115. Cystoscopy at the Time of Hysterectomy for Benign Indications and Delayed Lower Genitourinary Tract Injury. (PubMed)

Cystoscopy at the Time of Hysterectomy for Benign Indications and Delayed Lower Genitourinary Tract Injury. To compare the rate of delayed 30-day lower genitourinary tract injury in women who underwent cystoscopy at the time of hysterectomy for benign indications to those who did not.This was a retrospective cohort study of patients who underwent hysterectomy without a concomitant procedure for prolapse or incontinence for benign pathology with a general obstetrician-gynecologist (ob-gyn (...) ) recorded in the National Surgical Quality Improvement Program targeted hysterectomy file between 2015 and 2017. The primary outcome was a delayed lower genitourinary tract injury in the 30 days after hysterectomy. Secondary outcomes included urinary tract infection and operative time. The exposure of interest was cystoscopy at the time of hysterectomy. Stratified analysis was performed by route of surgery. Bivariable tests were used to examine associations.We identified 39,529 women who underwent

2019 Obstetrics and Gynecology

116. Predictive factors of severe perioperative morbidity of radical hysterectomy with lymphadenectomy in early-stage cervical cancer: A French prospective multicentric cohort of 248 patients. (PubMed)

Predictive factors of severe perioperative morbidity of radical hysterectomy with lymphadenectomy in early-stage cervical cancer: A French prospective multicentric cohort of 248 patients. The purpose of this study was to assess the postoperative morbidity after radical hysterectomy (RH) for early-stage cervical cancer and to determine risk factors of severe perioperative morbidity.Data of two prospective trials on sentinel node biopsy for cervical cancer (SENTICOL I & II) were analysed (...) . Patients having a radical hysterectomy were included between 2005 and 2012 from 25 French oncologic centers. Postoperative complications were prospectively recorded in a pre-specified analysis.248 patients met the inclusion criteria. The median age was 44.5 years [25-85]. 88.7% of patients had a stage IB1 disease. There were 71.4% epidermoid carcinomas and 25% adenocarcinomas. 125 patients (50.4%) had a laparoscopic-assisted vaginal RH, 88 patients (35.5%) had a total laparoscopic RH, 26 patients (10.5

2019 European Journal of Surgical Oncology

117. Delayed recognition of lower urinary tract injuries following hysterectomy for benign indications: a NSQIP-based study. (PubMed)

Delayed recognition of lower urinary tract injuries following hysterectomy for benign indications: a NSQIP-based study. To describe the incidence of and factors associated with lower urinary tract (LUT) complications recognized in the immediate postoperative period following hysterectomy for benign gynecologic indications using the National Surgical Quality Improvement Program (NSQIP) database.Patients who underwent hysterectomy for benign indications from 2014 through 2016 were identified (...) of 45,139 patients met inclusion criteria during the study period. Mean age and BMI were 31 ±11years and 32±8 kg/m2. The majority of patients were white (66%), had an ASA Class of 2 (67%), and had no major medical comorbidities (68%). The most commonly performed primary surgery was laparoscopic hysterectomy (43%), followed by abdominal hysterectomy (27%). The incidence of any LUT complication was 0.2% (95% CI 0.19-0.28): 55 ureteral obstructions (0.1%, 95%CI 0.09-0.16), 33 ureteral fistulae (0.07%, 95

2019 American Journal of Obstetrics and Gynecology

118. Is hysterectomy beneficial in radical cystectomy for female patient with urothelial carcinoma of bladder? A retrospective analysis of consecutive 112 cases from a single institution. (PubMed)

Is hysterectomy beneficial in radical cystectomy for female patient with urothelial carcinoma of bladder? A retrospective analysis of consecutive 112 cases from a single institution. There is no criterion for determining whether female patients operated with cystectomy would benefit from hysterectomy. This study compares the oncological outcomes between female patients receiving uterus preserving cystectomy (UPC) and uterus excision cystectomy (UEC).Retrospective review of 121 female patients (...) ) and PFS probability (p = 0.565) were similar in two groups. In multivariable Cox regression analysis, hysterectomy was not found to be a predictor of OS (hazard ratio 0.908, 95%CI 0.428-1.924, p = 0.801) and PFS (hazard ratio 1.109, 95%CI 0.439-2.805, p = 0.826) after adjusting for age, preoperative clinical stage, pathological stage, pathological nodal stage, neoadjuvant/adjuvant chemotherapy, location of the tumor, and surgical margin. No significant difference of overall survival probability

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2019 BMC Urology

119. Short-term recurrence and distant metastasis following robotic-assisted radical hysterectomy with pelvic lymphadenectomy and chemoradiotherapy for a stage IB1 cervical adenocarcinoma: A case report and literature review. (PubMed)

Short-term recurrence and distant metastasis following robotic-assisted radical hysterectomy with pelvic lymphadenectomy and chemoradiotherapy for a stage IB1 cervical adenocarcinoma: A case report and literature review. Postoperative concurrent chemoradiotherapy (CCRT) is considered the standard treatment for patients with early stage cervical cancer with positive pelvic nodes, yet many patients with high-risk factors treated with CCRT still suffered from distant metastasis.A 48-year-old woman (...) presented with abnormal vaginal bleeding for 5 months. Thin prep liquid-based cytology test revealed low-grade squamous intraepithelial lesion and the human papillomavirus test (type 58) was positive. Magnetic resonance imaging showed a mass measuring 17 × 15 mm, located predominantly in the posterior lip of uterine cervix. Colposcopy biopsy reported adenocarcinoma of the cervix.Cervical adenocarcinoma stage IB1.A robotic-assisted radical hysterectomy with pelvic lymphadenectomy was performed followed

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2019 Medicine

120. Hysterectomy-Corrected Uterine Corpus Cancer Incidence Trends and Differences in Relative Survival Reveal Racial Disparities and Rising Rates of Nonendometrioid Cancers. (PubMed)

Hysterectomy-Corrected Uterine Corpus Cancer Incidence Trends and Differences in Relative Survival Reveal Racial Disparities and Rising Rates of Nonendometrioid Cancers. Uterine corpus cancer incidence rates have been projected to increase, a prediction often attributed to the obesity epidemic. However, correct estimation of these rates requires accounting for hysterectomy prevalence, which varies by race, ethnicity, and region. Here, we evaluated recent trends in hysterectomy-corrected rates (...) by race and ethnicity and histologic subtype and estimated differences in relative survival by race and ethnicity, subtype, and stage.We estimated hysterectomy prevalence from the Behavioral Risk Factor Surveillance System. Hysterectomy-corrected age-standardized uterine corpus cancer incidence rates from 2000 to 2015 were calculated from the SEER 18 registries. Incidence rates and trends were estimated separately by race and ethnicity, region, and histologic subtype. Five-year relative survival rates

2019 Journal of Clinical Oncology

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