Reducing Fluid-Related Complications During Operative Hysteroscopy: Use of a New Mandatory Fluid-Balance Form

Alexandroni, Heli; Bahar, Raz; Chill, Henry H.; Karavani, Gilad; Ben-Yossef, Orna; Shushan, Asher

doi:10.1016/j.jmig.2017.06.014

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…Use of a fluid-balance form and mandatory reporting system has been shown to reduce the rate of total complications in hysteroscopic surgeries, particularly media-related complications. 20 Limitations of the present study include the small sample size and inability to monitor the patients with reproductive issues for a long duration.…”

Section: Discussionmentioning

confidence: 95%

Operative hysteroscopy platform at a university teaching hospital: a retrospective study

Al-Husban

Rokbeh

2019

J Int Med Res

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Objective This study was performed to investigate the prevalence, indications, effectiveness, outcomes, and complications of operative hysteroscopy in gynecological patients with an emphasis on the need for further training and equipping facilities as performed by consultant gynecologists. Methods This was a retrospective descriptive study of operative hysteroscopic procedures from 19 September 2016 to 31 December 2018. Results In total, 1919 hysteroscopic procedures were performed [1829 (95.3%) diagnostic and 90 (4.7%) operative hysteroscopies]. The patients’ mean age was 42.4 years (range, 20–69 years). The most common operative procedure was hysteroscopic fibroid polypectomy in 31 patients (34.4%), followed by transcervical resection of the endometrium in 23 (25.6%) and endometrial polypectomy in 16 (17.8%). The most common indication was menorrhagia in 57 patients (63.33%), followed by recurrent miscarriages in 9 (10.00%) and primary infertility in 5 (5.56%). Sixty-six patients (73.33%) were treated under general anesthesia and 24 (26.67%) under spinal anesthesia. Fifteen fibroids (48.4%) were 3 to 4 cm in size and 11 (35.5%) were >4 cm. Eight polyps (50%) were 3 to 4 cm. The mean uterine size and endometrial thickness were 8.9 ± 2.16 weeks and 11.1 ± 3.01 mm, respectively. The mean preoperative hemoglobin level was 10.9 g/dL and the mean estimated blood loss was 65.9 ± 48.7 mL (range, 10–200 mL). Thirty-eight patients (60.3%) with heavy bleeding improved with no need for further medical or surgical intervention. Eleven patients (44%) with reproductive issues conceived or regained their normal menstrual pattern. Two patients (2.2%) had excessive fluid absorption and one (1.1%) had uterine perforation. Conclusions Operative hysteroscopy was an effective and safe option in certain uterine pathologies. Specific training in operative hysteroscopy should be promoted to make this type of surgery an integral part of gynecological services in the developing world.

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Section: Discussionmentioning

confidence: 95%

Operative hysteroscopy platform at a university teaching hospital: a retrospective study

Al-Husban

Rokbeh

2019

J Int Med Res

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“…There are system improvements that could have reduced the risk in this patient, such as limiting the volume of intravenous fluid administered and using an alternative intravenous fluid to NS. Alexandroni et al [6] showed that a mandatory fluid balance form decreases the frequency of distension medium−related complications at hysteroscopy. These types of tools could be adapted to include intravenous fluid administered, providing a complete summary of a patient's fluid balance, and improve team communication.…”

Section: Figmentioning

confidence: 99%

A Case of Cardiac Arrhythmia from Absorption of Normal Saline during Hysteroscopic Myomectomy

Smith

Brown

2019

Journal of Minimally Invasive Gynecology

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“…Perioperative fluid therapy is an important factor that may affect the prognosis of patients undergoing surgery [ 1 , 2 , 3 ] and, therefore, it is an indispensable issue in clinical practice [ 4 ]. Several perioperative fluid management strategies have been studied so far; liberal and restrictive fluid therapies are two widely used regimens [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Cumulative Fluid Balance and Its Association with an Increase in Costs after Major Surgery

Hwang

Jeon

et al. 2018

JCM

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Positive fluid balance (FB) during the perioperative period may increase the incidence of postoperative complications, which may lead to longer hospitalization and higher hospital costs. However, a definitive association between positive FB and hospital costs has not yet been established. This retrospective observational study examined the association between perioperative FB and hospital costs of patients who underwent major surgical procedures. Medical records of patients who underwent major surgery (surgery time >2 h, estimated blood loss >500 mL) from January 2010 to December 2017 were analyzed to determine the associations between calculated FB (%, total input fluid—output fluid in liter/weight (kg) at admission) and total hospital cost ($). The analysis included medical data of 7010 patients. Multivariable linear regression analyses showed that a 1% increase in FB in postoperative day (POD) 0 (24 h), 0–1 (48 h), 0–2 (72 h), and 0–3 (96 h) significantly increased the total cost by $967.8 (95% confidence interval [CI]: 803.4–1132.1), $688.8 (95% CI: 566.3–811.2), $591 (95% CI: 485.7–696.4), and $434.2 (95% CI: 349.4–519.1), respectively (all p < 0.001). Perioperative cumulative FB was positively associated with hospital costs of patients who underwent major surgery.

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Reducing Fluid-Related Complications During Operative Hysteroscopy: Use of a New Mandatory Fluid-Balance Form

Cited by 6 publications

References 15 publications

Operative hysteroscopy platform at a university teaching hospital: a retrospective study

Operative hysteroscopy platform at a university teaching hospital: a retrospective study

A Case of Cardiac Arrhythmia from Absorption of Normal Saline during Hysteroscopic Myomectomy

Perioperative Cumulative Fluid Balance and Its Association with an Increase in Costs after Major Surgery

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