Acta obstetricia et gynecologica Scandinavica · 2006
Factors influencing laparoconversions during the learning curve of laparoscopic myomectomy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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.
Marret H, Chevillot M, Giraudeau B, Study Group of the French Society of Gynaecology and Obstetrics (Ouest Division)
Аннотация
BACKGROUND: To assess the probability of conversion of a laparoscopic myomectomy to an open procedure, we only found the score developed by Dubuisson et al. (2001) based on four preoperative risk factors. Routinely this score is not appropriate, as realized by the most skilled laparoscopic surgeons.
METHODS: The aim of this study was to identify the preoperative factors affecting the risk of conversion in data collected in different centers among a population of surgeons at the beginning of their experience in laparoscopic myomectomy. We collected preoperative clinical and ultrasonography data for all laparoscopic myomectomies performed in 11 hospital centers between January 1996 and December 2000. Data were available for 116 patients. Multiple logistic regression was use to develop a simple predictive model based on available preoperative risk factors of laparoconversion.
RESULTS: We encountered 33 laparoconversions (28%) compared to an expected number of 7.8 using Dubuisson's score. We confirmed the importance of two of the four risk factors in Dubuisson's model: biggest myoma size at ultrasonography (increased 1 mm) (OR: 1.06) and intramural type (OR: 3.25) of the dominant myoma. However, we also identified another risk factors: surgeon's experience (OR: 0.15). Simple score was calculated and used to provide an estimated risk of conversion.
CONCLUSION: Our model is a useful tool to predict laparoconversion for surgeons beginning in laparoscopic myomectomy. Ultrasound evaluation is essential before performing the procedure. Skilled surgeons in laparoscopy and in laparoscopic myomectomy must help their trainees during their learning curve in order to reduce laparoconversion rate.
METHODS: The aim of this study was to identify the preoperative factors affecting the risk of conversion in data collected in different centers among a population of surgeons at the beginning of their experience in laparoscopic myomectomy. We collected preoperative clinical and ultrasonography data for all laparoscopic myomectomies performed in 11 hospital centers between January 1996 and December 2000. Data were available for 116 patients. Multiple logistic regression was use to develop a simple predictive model based on available preoperative risk factors of laparoconversion.
RESULTS: We encountered 33 laparoconversions (28%) compared to an expected number of 7.8 using Dubuisson's score. We confirmed the importance of two of the four risk factors in Dubuisson's model: biggest myoma size at ultrasonography (increased 1 mm) (OR: 1.06) and intramural type (OR: 3.25) of the dominant myoma. However, we also identified another risk factors: surgeon's experience (OR: 0.15). Simple score was calculated and used to provide an estimated risk of conversion.
CONCLUSION: Our model is a useful tool to predict laparoconversion for surgeons beginning in laparoscopic myomectomy. Ultrasound evaluation is essential before performing the procedure. Skilled surgeons in laparoscopy and in laparoscopic myomectomy must help their trainees during their learning curve in order to reduce laparoconversion rate.