Journal of minimally invasive gynecology · 2005
Total laparoscopic hysterectomy: preoperative risk factors for conversion to laparotomy.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Leonard Franck, Chopin Nicolas, Borghese Bruno, Fotso Adolphe, Foulot Hervé, Coste Joël, Mignon Alexandre, Chapron Charles
Аннотация
STUDY OBJECTIVE: To identify the preoperative factors affecting the risk of conversion to laparotomy during total laparoscopic hysterectomy (TLH) indicated for benign conditions (surgery performed in cases of genital prolapse and/or urinary stress incontinence was excluded).
DESIGN: Retrospective comparative study (Canadian Task Force classification II-2).
SETTING: University tertiary referral center for gynecologic endoscopic surgery.
PATIENTS: Four hundred sixteen consecutive patients who underwent TLH during the first 5 years of our experience performing TLH.
INTERVENTION: Total laparoscopic hysterectomy.
MEASUREMENTS AND MAIN RESULTS: The rate of conversion to laparotomy was 7% (29 patients). Factors that were found to be independently related to the risk of conversion to laparotomy are the following: body mass index (adjusted OR 1.09; 95% CI 1.01-1.18); uterine width on transvaginal ultrasonography (US) between 8 and 10 cm (adjusted OR 4.01; 95% CI 1.54-10.45); uterine width on US greater than 10 cm (adjusted OR 9.17; 95% CI 2.74-30.63); lateral myoma measuring greater than 5 cm on US (adjusted OR 3.57; 95% CI 0.97-13.17); history of adhesion-causing abdominopelvic surgery (adjusted OR 2.92; 95% CI 1.23-6.94).
CONCLUSION: Transvaginal US evaluation is essential before performing TLH. Awareness of the risk factors for conversion to laparotomy is essential for proper patient information and better selection of patients.
DESIGN: Retrospective comparative study (Canadian Task Force classification II-2).
SETTING: University tertiary referral center for gynecologic endoscopic surgery.
PATIENTS: Four hundred sixteen consecutive patients who underwent TLH during the first 5 years of our experience performing TLH.
INTERVENTION: Total laparoscopic hysterectomy.
MEASUREMENTS AND MAIN RESULTS: The rate of conversion to laparotomy was 7% (29 patients). Factors that were found to be independently related to the risk of conversion to laparotomy are the following: body mass index (adjusted OR 1.09; 95% CI 1.01-1.18); uterine width on transvaginal ultrasonography (US) between 8 and 10 cm (adjusted OR 4.01; 95% CI 1.54-10.45); uterine width on US greater than 10 cm (adjusted OR 9.17; 95% CI 2.74-30.63); lateral myoma measuring greater than 5 cm on US (adjusted OR 3.57; 95% CI 0.97-13.17); history of adhesion-causing abdominopelvic surgery (adjusted OR 2.92; 95% CI 1.23-6.94).
CONCLUSION: Transvaginal US evaluation is essential before performing TLH. Awareness of the risk factors for conversion to laparotomy is essential for proper patient information and better selection of patients.