Intrafascial abdominal hysterectomy: outcomes and complications of 867 operations

Conde-Agudelo, Agustín

doi:10.1016/s0020-7292(99)00197-6

Cited by 11 publications

(9 citation statements)

References 11 publications

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“…8 The rate of operative-site infection in the present series was very low. This is consistent with the rates reported in other series examining intrafascial abdominal hysterectomy, 4% in the Conde-Agudelo study 6 and 4.8% in the Kaya et al study. 12 Apart from the use of antibiotics, the low incidence of operative-site infection associated with intrafascial hysterectomy could be related to the effective hemostasis and obliteration of the dead space at the vaginal vault.…”

Section: Discussionsupporting

confidence: 92%

“…9 The rate of intraoperative blood loss of > 1000 mL was 6.2% in the current study, 14 CHAROENKWAN which was higher than those previously mentioned. In the prospective cohort study of intrafascial hysterectomy by Conde-Agudelo, 6 blood loss was 286 -112 mL and that was comparable to the median blood loss of 200 mL in the present study, but the rate of intraoperative blood loss or blood transfusion of 0.2% was much lower. The higher rate of intraoperative blood loss in the current series of patients could be explained by the fact that a significant proportion (40%) of the cases involved severe adhesions or large/ distorted uteri.…”

Section: Discussionsupporting

confidence: 78%

“…However, there are surprisingly few detailed surgical illustrations and operative data for this highly beneficial technique in current literature and gynecologic surgery textbooks. 6,7 This indicates clearly the lack of proper attention to this extremely valuable procedure. Many young gynecologists never have a chance to observe or learn to perform this procedure.…”

Section: Introductionmentioning

confidence: 99%

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The Intrafascial Technique for Total Abdominal Hysterectomy: Revisiting the Valuable Classic Procedure

Charoenkwan

2015

Journal of Gynecologic Surgery

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Background: Total abdominal hysterectomy (TAH) is frequently performed for benign gynecologic conditions with the presence of a large distorted uterus and/or severe extrauterine diseases such as pelvic endometriosis or adhesion. Operative injury to adjacent organs is a major concern. Performing the procedure by using intrafascial approach has many potential benefits in preventing complications. Objective: The aim of this research was to illustrate the intrafascial technique for TAH as performed at the Faculty of Medicine, Chiang Mai University, in Chang Mai, Thailand, and to describe clinical and operative outcomes of patients with benign gynecologic conditions who underwent TAH including this technique. Materials and Methods: For this study, retrospective reviews were performed, using clinical, operative, and pathologic data from all patients who underwent TAH with the intrafascial technique for benign gynecologic conditions from January 2003 to December 2012. Descriptive statistics were used to elucidate the surgical outcomes. Results: The intrafascial technique was used in 161 patients undergoing TAH. Approximately 40% of the patients had severe pelvic pathology. All procedures were accomplished without injuries to surrounding organs. The rate of operative complications was low. Conclusions: The intrafascial technique for TAH is a simple procedure that provides many benefits including low risk of injury to surrounding structures, a well-supported vaginal vault, obliteration of dead space, and effective hemostasis. However, the procedure has been largely neglected by the gynecologic community. For modern gynecologists to be able to perform safe abdominal hysterectomy, knowledge of this intrafascial technique is crucial. ( J GYNECOL SURG 31:11)

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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The Intrafascial Technique for Total Abdominal Hysterectomy: Revisiting the Valuable Classic Procedure

Charoenkwan

2015

Journal of Gynecologic Surgery

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“…The preservation of the pubovesicocervical fascia during the intrafascial technique of abdominal hysterectomy may theoretically reduce damage to the paravaginal nerve bundles that supply the anterior vaginal wall and vesical neck [8]. The intrafascial operation is generally believed to decrease the incidence of ureteral and bladder injury as well [9]. It is hypothesized that blunt dissection with gauze during the extrafascial technique may disrupt the paravaginal nerve bundles and create the opportunities for mediumterm complications like urge incontinence by causing denervation of the urethrovesical junction [10].…”

Section: Discussionmentioning

confidence: 99%

Intrafascial versus extrafascial abdominal hysterectomy: effects on urinary urge incontinence

Kaya

Sezi̇k

Özbaşar

et al. 2004

International Urogynecology Journal and Pelvic Floor Dysfunctio

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Our aim was to evaluate urinary urge incontinence following intrafascial and extrafascial abdominal hysterectomies in a prospective randomized study. Women scheduled for total abdominal hysterectomy were randomized to the extrafascial (n=38) and the intrafascial techniques (n=42). The groups were controlled for demographic variables, obstetric and gynecologic history, uterine size, indications for hysterectomy, and preoperative hemoglobin values. Short-term surgical morbidity and presence of urge incontinence defined as urodynamically established detrusor overactivity at the end of 12 months were the main outcome measures. Major surgical morbidity did not differ between the two groups. Percentages of women with urge incontinence at the end of the follow-up period were also similar. However, when women with pre-existing urge incontinence were evaluated separately, there was a trend towards the intrafascial operation to be associated with more urge-incontinence-free patients at the end of the follow-up period ( p=0.06, borderline significant). As a result, short-term surgical morbidity seems to be similar across the intrafascial and extrafascial techniques of abdominal hysterectomy. The effects of intrafascial abdominal hysterectomy on women presenting with urge incontinence in the preoperative period merit further investigation.

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“…1 Rectal injury during hysterectomy in the presence of adhesions and obliterated pouch of Douglas is a feared complication. Precautions to prevent this injury and intraoperative diagnosis and repair in case this injury occurs can prevent the development of rectovaginal fistula.…”

Section: Discussionmentioning

confidence: 99%

Rectovaginal Fistula After Abdominal Hysterectomy and Its Repair: Report of a Case

Malhotra

Deka

Srivastava

2002

Journal of Gynecologic Surgery

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We present a case report of a rectovaginal fistula following an abdominal hysterectomy and its subsequent repair. A rectovaginal fistula developing after abdominal hysterectomy for a benign pathology is very rare. Sharp dissection and care during surgery reduces the risk of intraoperative trauma, which may lead to fistula formation. Multilayered closure of the fistula is recommended in the literature. We successfully repaired it by a previously unreported two-layer method. (J GYNECOL SURG 23)

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Intrafascial abdominal hysterectomy: outcomes and complications of 867 operations

Abstract: Intrafascial abdominal hysterectomy is a safe technique with a low rate of complications.

Cited by 11 publications

References 11 publications

The Intrafascial Technique for Total Abdominal Hysterectomy: Revisiting the Valuable Classic Procedure

The Intrafascial Technique for Total Abdominal Hysterectomy: Revisiting the Valuable Classic Procedure

Intrafascial versus extrafascial abdominal hysterectomy: effects on urinary urge incontinence

Rectovaginal Fistula After Abdominal Hysterectomy and Its Repair: Report of a Case

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