Laparoscopic supracervical hysterectomy (LSH) versus total laparoscopic hysterectomy (TLH): an implementation study in 1,952 patients with an analysis of risk factors for conversion to laparotomy and complications, and of procedure-specific re-operations

Abstract

Both procedures proved effective and were well tolerated. LSH performed better than TLH regarding most outcome measures. LSH is associated with very low rates of re-operation and spotting.

Laparoscopic Supracervical Hysterectomy With Transcervical Morcellation: Our Experience

“…Thus, we had a real percentage of postoperative complications that required surgery with the actual instrumentation of about 0.55% in agreement with the literature [14,15]. In fact, a recent prospective analysis of 1952 patients undergoing LSH or TLH, respectively, reported a 0.6% and 4.8% rate of shortterm complications requiring reoperation (p , .001) and a 0.8% and 1.7% rate of long-term complications requiring surgery (p 5 .173) [15]. Persistent bleeding presented in 1.3% of women; all of them were treated with outpatient coagulation, with no further complications.…”

CA125 modified by PLT and NLR improves the predictive accuracy of adenomyosis-derived pelvic dense adhesion

“…Based on the literature data [5] and the intraoperative real-time observation, the adenomyosis-derived PDA was defined as follows: The adenomyosis lesion was invasively adhered to the surrounding tissue or organ, such as the rectum, sigmoid colon, utero-sacral ligament, cardinal ligament, and bladder, forming a dense adherent zone, from which some coffee-colored secretion flowed out when pelvic adhesiolysis was performed in most cases. Adenomyosis was complicated with chocolate cyst of ovary and peritoneal endometriosis, leading to adhesion between the cyst and the ovarian fossa.…”

“…[4] Recent data from patients who underwent laparoscopic hysterectomy showed that patients who required extensive adhesiolysis had a significantly increased odds ratio (OR) of 2.22 for conversion to laparotomy, and 3.5 for short-term postoperative complications (pelvic peritonitis, hematoma requiring surgical intervention, postoperative bleeding, and reoperation due to adhesions) relative to patients without adhesiolysis. [5] The pathological changes in pelvic cavity of adenomyosis are so complicated and at high risk of suffering from tissue and organ damage that making an accurate preoperative assessment on the presence or absence of PDA in adenomyosis patients has positive guiding significance for gynecologic surgeons. It is therefore necessary to seek a noninvasive, effective, and mature alternative for the clinical diagnosis of PDA.…”

Operative Optionen bei Uterus myomatosus

“…Die laparoskopische suprazervikale Hysterektomie (LASH) erweist sich in Bezug auf intra-und postoperative Komplikationsraten, die Operationszeit, Blutverluste und die Rekonvaleszenz auch im Vergleich zur totalen laparoskopischen Hysterektomie (TLH) als vorteilhaft [34]. Auch was Lebensqualität und Sexualleben betrifft, konnte für den Erhalt des Gebär-mutterhalses ein Vorteil der LASH gegenüber der TLH gezeigt werden [35].…”