Author/Editor     Kobal, Borut; Omahen, Andrej; Ribič-Pucelj, Martina; Cvjetičanin, Branko; Barbič, Matija; Tomaževič, Tomaž; Senčar, Sabina
Title     Laparoskopska histerektomija na Ginekološki kliniki v Ljubljani: obdobje 1999-2003
Translated title     Laparoscopic hysterectomy at the University medical centre Ljubljana, division of gynecology and reproduction, between 1999-2003
Type     članek
Source     Endoskopska revija
Vol. and No.     Letnik 8, št. 20-21
Publication year     2003
Volume     str. 113-20
Language     slo
Abstract     Objective. The purpose of this study was to analyse the indications for intra- and postoperative parameters and complications of laparoscopic hysterectomy (LH) at the Department of Obstetrics and Gynecology, University Medical Centre Ljubljana. Patieuts aud methods. A retrospective analysis covered the period 1999-2003. Patients' records were reviewed for the indications and type of LH as well as for the blood loss and duration of surgery, postoperative hospital stay, and postoperative early and late complications. In the analysed period, 85 LH were performed: 32 (37.6%) between 1999-2001, 30 (35.2%) in 2002, and 23 (27%) by 15 April 2003. For the purposes of analysis, the patients were divided into two subgroups; the subgroup of patients with laparoscopically assisted vaginal hysterectomy (LAVH) with laparoscopic pelvic lymphadenectomy (LPL), and the subgroup with supracervical hysterectomy (SLH). Results. In the LAVH subgroup, uterine arteries were ligated in 17 patients, and in 49 adnexectomy, resection of the round ligament, and opening of the utero-vesical space were performed laparoscopically, while the uterine artery was ligated in the vaginal part of the procedure. In the SLH subgroup, there were 19 patients. The indications for LH were as follows: CIN or early cervical cancer (n=10), endometrial cancer (n=17), myomas (n=32), endometrial hyperplasia (n=3), irregular bleeding (n=2), adenomyosis (n=14), serous ovarian cystadenoma (n=4), and post-PID seguelae (n=1). The median age of 85 women was 48.24 (33-76) years, the mean duration of LH was 2.16 (1.5-3.5) hours, the mean blood loss was 359 (100-800) ml. Due to intraoperative blood loss, I LAVH was converted to laparotomy; for the same reason, open laparotomy was performed in 2 patients in early postoperative period. (Abstract truncated at 2000 characters).
Summary     Izhodišča. Analiza indikacij, oblik, operativnih in pooperativnih parametrov ter zapletov pri laparoskopskih histerektomijah (LH), narejenih na Ginekološki kliniki (GK) v Ljubljani v obdobju 1999-2003. Bolnice in metode. Za retrospektivno analizo LH smo podatke o indikacijah in obliki LH zajemali iz operativnih zapisnikov, podatke o trajanju operacije in izgubi krvi iz anestezijskih poročil, podatke o trajanju bolnišničnega zdravljenja ter zgodnjih in kasnih pooperativnih zapletih pa iz popisov operirank. V analiziranem obdobju smo na GK v letih 1999-2001 naredili 32 (37,6%), v letu 2002 30 (35,2%) in do 15. aprila 2003 23 (27%), skupaj 85 različnih oblik LH. Za potrebe analize smo med operirankami ustvarili dve podskupini, in sicer podskupino bolnic, pri katerih smo naredili laparoskopsko asistirano vaginalno histerektomijo (LAVH) s pelvično limfadenektomijo, in podskupino, pri kateri smo naredili supracervikalno laparoskopsko histerektomijo (SLH). Rezultati. Definicija oblike LH je pokazala 17 LAVH s podvezanjem uterinih arterij, 19 SLH, v 49 primerih pa smo pri LAVH napravili adneksektomijo, resekcijo ligg rotunduma ter resekcijo peritoneja med mehurjem in maternico, uterino arterijo pa podvezali v vaginalnem delu operacije. Indikacije za LH so bile: prekanceroza ali zgodnji rak materničnega vratu (n=10), karcinom endometrija (n=17), miomi maternice (n=32), hiperplazija endometrija (n=3), nepravilne krvavitve (n=2), endometrioza maternice in/ali adneksov (n=14), serozni cistadenom jajčnika (n=4) in povnetne spremembe (n=1). Povprečna starost vseh 85 operirank z LH je bila 48,24 (33-76) let, povprečen čas trajanja operacije 2,16 (1,5-3,5) ure, povprečna izguba krvi pa je znašala 359 (100-800) ml. V enem primeru smo zaradi krvavitve konvertirali v laparotomijo, pri dveh bolnicah smo iz istega razloga izvedli odprto pooperativno revizijo. (Izvleček skrajšan pri 2000 znakih).
Descriptors     HYSTERECTOMY, VAGINAL
LAPAROSCOPY
LYMPH NODE EXCISION
AGE FACTORS
POSTOPERATIVE COMPLICATIONS