Bladder and ureteral injuries during benign hysterectomy: an observational cohort analysis in New York State

Benson, Cooper; Thompson, Stephanie; Li, Gen; Asafu-Adjei, Denise; Brandes, Steven B.

doi:10.1007/s00345-018-2541-y

Cited by 11 publications

(13 citation statements)

References 21 publications

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“…The total operative time in TLH was significantly longer than TAH. This is due to the smaller field of vision and being technically advanced method of surgery requiring more experience on the part of surgeon as dealing with the anatomy in the pelvis during TLH is difficult, thereby increasing the procedure time and requiring more attention to complications, such as intraoperative bladder & ureteral injury, than TAH [8,9] . Also, careful maintenance of hemostasis using an enlarged visual field and that of the transvaginal uterine manipulations are time consuming [12] .…”

Section: Discussionmentioning

confidence: 99%

“…Authors opine that operation time can be shortened along with improvement of the technique of the operator. Meanwhile, Taniguchi F et.al have reported that in TLH minor complications have decreased while serious complications have increased [9] . Komatsu et al have reported that the procedures that greatly affect the operation time are ureteral identification and uterine artery processing on the learning curve of TLH [11] .…”

Section: Discussionmentioning

confidence: 99%

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A comparative study between Total Laparoscopic Hysterectomy (TLH) and conventional Total Abdominal Hysterectomy (TAH) in non-neoplastic uterine diseases

Gupta¹,

Chandra²,

Kulshrestha³

et al. 2020

Int. J. Clin. Obstet. Gynaecol.

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Introduction: In the past decade, laparoscopic route of surgery has been on an increase especially for nonneoplastic uterine diseases. The present study aims to study and compare between Total Laparoscopic Hysterectomy (TLH) and conventional TAH (Total Abdominal Hysterectomy) in terms of characteristics like blood loss, operative time, intraoperative complications, postoperative pain & mobilisation, analgesic requirements, duration of hospital stay and finally patient satisfaction. Materials and methods: In this randomized prospective comparative study, 100 consecutive patients of hysterectomy (50 each of total TAH and TLH) at a tertiary care center in western India, were recruited. The present study aims to study and compare between TLH and conventional TAH (Total Abdominal Hysterectomy), in non-neoplastic uterine diseases, in terms of characteristics like blood loss, operative time, intraoperative complications, postoperative pain & mobilisation, analgesic requirements, duration of hospital stay and finally patient satisfaction. Results: We observed that average blood loss, postoperative pain and analgesic requirement and mean length of hospital stay in TLH was lesser than TAH group (p< 0.001). An average time taken for TLH as well as patient satisfaction level was more (p< 0.001) than that in TAH group. Intraoperative complications were comparable and not significantly different among the two procedures. Mobilization after the procedure was quicker in laparoscopic hysterectomy. Mobilization of patients during postoperative period was significantly earlier (p< 0.0001) in TLH group (12.2 hours) while in TAH (22.3 hours. Patient satisfaction level was 90% in patients in TLH group while only 60% for patients in TAH group. Conclusion: TLH is a safe and effective method of doing hysterectomy and it is a good alternative of conventional abdominal hysterectomy, especially after good training to standardized the procedure, proper case selection, day to day practice of the technique and application of sound surgical principles.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A comparative study between Total Laparoscopic Hysterectomy (TLH) and conventional Total Abdominal Hysterectomy (TAH) in non-neoplastic uterine diseases

Gupta¹,

Chandra²,

Kulshrestha³

et al. 2020

Int. J. Clin. Obstet. Gynaecol.

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4] However, identifying the anatomy in the pelvis during TLH is difficult, thereby prolonging the operation time and requiring more attention to complications, such as intraoperative bladder and ureteral injury, than ATH. 5,6 Meanwhile, in TLH minor complications have decreased while serious complications have increased. 9 In our study, intraoperative blood loss was less in TLH.…”

Section: Discussionmentioning

confidence: 99%

“…Perioperative complications such as ureteral injury and bladder injury have been extensively studied. 5,6 In this study, we aimed to examine whether TLH is being implemented safely and appropriately compared with ATH in our hospital.…”

mentioning

confidence: 99%

Comparison of Total Laparoscopic Hysterectomy with Abdominal Total Hysterectomy in Patients with Benign Disease: A Retrospective Cohort Study

et al. 2019

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Background The present study aimed to determine whether total laparoscopic hysterectomy (TLH) is being implemented safely and appropriately compared with abdominal total hysterectomy (ATH) in our hospital. Methods We retrospectively reviewed clinical records of 102 patients who underwent total hysterectomy for benign gynecological disease at Japanese Red Cross Yamaguchi Hospital from January 2017 to August 2018. We examined periods of hospital stay, operation time, blood loss, weight of the uterus, frequency of perioperative complications, and the duration from the first visit to the date of surgery. P < 0.05 was considered to be statistically significant indicated statistical significance. Results TLH and ATH were performed in 55 (53%) and 47 (46%) cases, respectively. The TLH group had significantly longer total operation time [133 (82-205) min vs. 87 (57-155) min, P < 0.0001], lesser blood loss [5 (5-35) g vs. 100 (10-820) g, P < 0.0001], shorter hospital stay [7 (5-14) days vs. 10 (9-26) days, P < 0.0001], and lighter uterine weight [206 (27-658) g vs. 554 (79-2284) g, P < 0.0001] than the ATH group. The frequency of perioperative complications did not differ between the two groups (3.5% vs. 8.0%, P = 0.4103). Conclusion TLH had a longer operation time and a lesser excised uterine weight, but it had less intraoperative blood loss, shorter hospital stay, and no difference in perioperative complication frequency when compared with ATH.

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“…Some studies suggest that TLH appears to be associated with significantly greater rate of complications than other routes of surgical approachs [5,6]. Many randomized controlled trials found that laparoscopic route has a tendency to cause more bladder or ureteral injuries [5,7,8]. Furthermore, all these complications of TLH depend mainly on the surgeon's experience [9].…”

Section: Introductionmentioning

confidence: 99%

Impact of clinicopathological variables on laparoscopic hysterectomy complications, a tertiary center experience

Akgör

Kuru²,

Güneş

et al. 2022

Ginekol Pol

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Objectives:To analyze intraoperative and postoperative complications according to Clavian-Dindo Classification (CDC) and evaluate the influence of clinicopathological features on the feasibility and safety of total laparoscopic hysterectomy (TLH) in patients that underwent surgery in a tertiary center. Material and methods:We retrospectively reviewed the database of 469 patients that underwent surgery for patients who underwent extra facial TLH from 2013 to 2020.Results: A total of 86 (18.3%) peri-postoperative complications were observed. The incidence of intraoperative complications was 2% (n = 10). The overall conversion rate to open surgery was 1.9% (n = 9). A total of 76 postoperative complications were observed in 61 patients (14.3%). The incidence of minor (Grade I [n = 16, 3.4%] and II [n = 42, 8.9%]) and major complications (Grade III [n = 15, 3.2%], IV [n = 2, 0.4%] and V [n = 1, 0.2 %]) were 12.3% and 3.8%, respectively.A higher BMI and performing surgery at the first step of learning are found to be associated with intraoperative and postoperative complications (p < 0.05). Postoperative complications related to having a history of the cesarean section, additional comorbidities, and uterine weight ≥ 300 g (p < 0.05). Conclusions:The implementation of TLH by experienced surgeons appears to have remarkable advantages over open surgery. However, the risk factor for complications should be taken into account by surgeons in the learning curve in selecting the appropriate patient for surgery.

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Bladder and ureteral injuries during benign hysterectomy: an observational cohort analysis in New York State

Cited by 11 publications

References 21 publications

A comparative study between Total Laparoscopic Hysterectomy (TLH) and conventional Total Abdominal Hysterectomy (TAH) in non-neoplastic uterine diseases

A comparative study between Total Laparoscopic Hysterectomy (TLH) and conventional Total Abdominal Hysterectomy (TAH) in non-neoplastic uterine diseases

Comparison of Total Laparoscopic Hysterectomy with Abdominal Total Hysterectomy in Patients with Benign Disease: A Retrospective Cohort Study

Impact of clinicopathological variables on laparoscopic hysterectomy complications, a tertiary center experience

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