Comparing benign laparoscopic and abdominal hysterectomy outcomes by time

Margulies, Samantha L.; Vargas, Maria V.; Denny, Kathryn; Sparks, Andrew; Marfori, Cherie Q.; Moawad, Gaby; Amdur, Richard L.

doi:10.1007/s00464-019-06825-8

Cited by 22 publications

(21 citation statements)

References 27 publications

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“…Minimally invasive surgical approaches are becoming increasingly common, and account for upwards of 93% of all surgeries (36). Laparoscopic hysterectomies are minimally invasive and entail reductions in hospitalization duration, blood loss, and postoperative pain, but they have a number of disadvantages, including a longer operative duration than that required for the traditional abdominal approach, which is noteworthy given that operative prolongation has been linked to adverse outcomes irrespective of the surgical approach (37). Further, in addition to inducing negative postoperative reactions, such as sleep disorders, changes in body positioning and the need to establish artificial pneumoperitoneum during the laparoscopic procedure can alter respiratory function and cardiac output (7).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the efficacy and safety of intradermal needle therapy on the sleep quality of patients following laparoscopic hysterectomy: study protocol for a randomized controlled trial

He¹,

Gong²,

Jing-ling³

et al. 2022

Ann Transl Med

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Background: Sleep disorder is a commonly reported complication in patients who have undergone a hysterectomy, which increases perioperative complications and delays patient recovery. Several pharmacological and non-pharmacological approaches have been employed to improve the quality of sleep of patients during the postoperative period, but these strategies have certain limitations. Intradermal needle therapy is now among the most common treatments for insomnia in traditional Chinese medicine (TCM).The present study was developed to explore the effects of intradermal needle therapy (as an adjunct to physiotherapy-based treatments for postoperative sleep impairment) on the postoperative sleep quality of patients who have undergone a laparoscopic hysterectomy.Methods: This is a prospective, single-center, single-blind, randomized controlled trial. In total, 80 eligible patients will be randomly allocated to the control and experimental groups at a 1:1 ratio. Random numbers and grouping schemes will be generated using the SPSS 25.0 software package. Following the completion of the laparoscopic hysterectomy procedure, the patients will be returned to the medical ward and undergo authentic or sham intradermal needle therapy as appropriate. For patients in the experimental group, following sterilization, intradermal needles will be inserted into the bilaterally "Shenmen" (HT36) and "Sanyinjiao" (SP6) acupoints; the needles will be replaced after 24 h. False intradermal needles that exhibit similar surface characteristics but lack needles will be employed in the control group. Patients will undergo a single 3-day treatment course. The primary outcome is the Pittsburgh Sleep Quality Index. The secondary outcomes are the 10-Item Short-Form Identity-Consequence Fatigue Scale, the Hospital Anxiety and Depression Scale-Anxiety, and postoperative pain scores, which will be rated using a visual analog scale. Time to postoperative defecation and the duration of hospitalization will also be recorded.Discussion: The present study seeks to examine the efficacy of the intradermal needle as a therapeutic tool for improving the sleep quality of patients after surgery who have undergone a laparoscopic hysterectomy to provide a foundation for future large-scale clinical studies.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the efficacy and safety of intradermal needle therapy on the sleep quality of patients following laparoscopic hysterectomy: study protocol for a randomized controlled trial

He¹,

Gong²,

Jing-ling³

et al. 2022

Ann Transl Med

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“…In our regression model, age was categorized into greater than 65 and less than or equal to 65 years, and preoperative hematocrit was categorized into greater or equal to 36 and less than 36 (anemia). In addition, operative time was further categorized into 60-minute intervals as done in previous ACS NSQIP studies because 60-minute intervals are recognizable and applicable in clinical practice 31,32 …”

Section: Methodsmentioning

confidence: 99%

“…In addition, operative time was further categorized into 60-minute intervals as done in previous ACS NSQIP studies because 60-minute intervals are recognizable and applicable in clinical practice. 31,32 The secondary outcome was composite 30-day complication rates. Following the Clavien-Dindo Classification of Surgical Complications and other ACS NSQIP studies, 33,34 composite rate was defined by minor complications (urinary tract infection, superficial SSI, or pneumonia) plus major complications (unplanned reintubation, deep SSI, organ SSI, deep vein thrombosis, pulmonary embolism, blood transfusion, return to the operating room, myocardial infarction, cardiac arrest, and stroke).…”

Section: Methodsmentioning

confidence: 99%

Trends in Same-Day Discharge Rate After Minimally Invasive Sacrocolpopexy and Propensity Score–Matched Analysis of Postoperative Complication Rates Using the National Surgical Quality Improvement Program Database

Kim

Hong

Harvie

2022

Female Pelvic Med Reconstr Surg

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ObjectiveThe primary aim of this study was to review trends in the same-day discharge (SDD) rate after minimally invasive sacrocolpopexy (MISCP). The secondary aim was to compare the composite 30-day postoperative complication rates between propensity score–matched SDD and admitted cohorts.MethodsThis was a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2015 to 2019. Patients who underwent MISCP were identified by Current Procedural Terminology codes. Concurrent hysterectomy, anterior or posterior repairs, rectopexy, and midurethral sling were also identified. Multivariable logistic regression and propensity score matching were performed.ResultsA total of 12,762 MISCP patients were captured: 3,968 underwent MISCP only, 4,065 underwent MISCP with total laparoscopic hysterectomy, 734 underwent MISCP with laparoscopically assisted vaginal hysterectomy, and 3,995 underwent MISCP with laparoscopic supracervical hysterectomy. Overall, the SDD rate was 16.3%, with an increase from 12.3% in 2015 to 23.1% in 2019. Multivariable logistic regression showed that admitted patients were more likely to be older, to be of Black race, have an American Society of Anesthesiologists classification of 3 or 4, have hypertension requiring medication, have longer operative time, and have undergone concurrent anterior or posterior repair, rectopexy, or sling. After propensity score matching, the composite postoperative complication rates were similar between the 2 cohorts (5.7% vs 6.4%, P = 0.818). However, superficial surgical site infection was more likely in the SDD cohort (adjusted odds ratio, 2.3; P < 0.001) and blood transfusion in the admitted cohort (adjusted odds ratio, 11.9; P = 0.0.34).ConclusionsThe rate of SDD after MISCP seems to be increasing. Composite postoperative complication rates are similar between SDD and admitted cohorts.

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“…Laparoscopic hysterectomy is currently considered the gold standard for the treatment of benign uterine or premalignant diseases [1]. This surgery was performed for the first time by Harry Reich in 1988 [2] and in the past years, many studies have shown the advantages of the laparoscopic approach, with decreases in postoperative complication rates, less operative bleeding, less postoperative pain, and shorter postoperative hospital stays compared to abdominal hysterectomy [3].…”

Section: Introductionmentioning

confidence: 99%

A randomized, controlled trial comparing the clinical outcomes of 3D versus 2D laparoscopic hysterectomy

Song¹,

Kang²

2022

wiitm

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Introduction:There have been a few clinical studies on the use of three-dimensional (3D) laparoscopy with different results. Aim: To compare the surgical outcomes of 3D versus two-dimensional (2D) laparoscopic hysterectomy for benign or premalignant gynecologic diseases. Material and methods: In this double-blind trial, 68 patients were randomly assigned to either the 3D or 2D groups at a 1 : 1 ratio. The only difference between the two groups was the laparoscopic vision system used. The primary outcome was operative blood loss and operative time. The other surgical outcomes including failure of the intended surgery, length of hospital stay, and operative complications were also assessed. Results: The baseline characteristics did not statistically significantly differ between the groups. The mean operative blood loss was not significantly different between the 3D group (74.4 ±51.6 ml) and the 2D group (79.2 ±55.4 ml) (p = 0.743). The operative time was similar in both groups (84.5 ±20.5 min vs. 87.8 ±24.4 min, p = 0.452). Moreover, no differences were observed between the groups in other surgical outcomes. Conclusions: The 3D imaging system had no surgical advantage in laparoscopic hysterectomy for benign or premalignant gynecologic diseases. However, 3D laparoscopy did not have any negative effects on surgical outcomes and did not increase the surgical risk.

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Comparing benign laparoscopic and abdominal hysterectomy outcomes by time

Cited by 22 publications

References 27 publications

Evaluation of the efficacy and safety of intradermal needle therapy on the sleep quality of patients following laparoscopic hysterectomy: study protocol for a randomized controlled trial

Evaluation of the efficacy and safety of intradermal needle therapy on the sleep quality of patients following laparoscopic hysterectomy: study protocol for a randomized controlled trial

Trends in Same-Day Discharge Rate After Minimally Invasive Sacrocolpopexy and Propensity Score–Matched Analysis of Postoperative Complication Rates Using the National Surgical Quality Improvement Program Database

A randomized, controlled trial comparing the clinical outcomes of 3D versus 2D laparoscopic hysterectomy

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