The Trend of the Technicity Index of Hysterectomy in a Tertiary Hospital in sub – Sahara Africa

Abstract

Introduction: Therefore the technicity index (TI), an indicator of performance is the percentage of the number of vaginal and laparoscopic hysterectomies, over the number of hysterectomies performed during a year in a service. Objective: To evaluate the trend of the technicity index of hysterectomies at Douala General Hospital. Materials and Methods: From January 2010 to December 2015, we selected on a retrospective study only patients who could benefit from the 03 surgical route performed in the obstetrics and gynecology department at the Douala General Hospital, Cameroon. The cumulative frequencies for all types of hysterectomies were tallied and the year-specific technicity index was calculated. Results: One hundred and sixteen cases were selected. The mean age was 49 ± 9.0 years. Symptomatic fibroids (75.0 %, 87 cases) and atypical hyperplasia of the endometrium (22.4% (26 cases) were the main indications of hysterectomy. Laparotomy was the main route, 87.1%, 101 cases) followed by vaginal hysterectomy, (9.5%, 11 cases) and laparoscopic hysterectomy (3.0%, 4 cases); we observed a fluctuating but decreasing TI from 25% to 8.3% with a mean TI evaluated at 12.9%. Conclusion: The technicity index is low. It has been fluctuating but decreasing during the 06 previous years at the Douala General Hospital. This is explained by the few number of vaginal and laparoscopic hysterectomies performed. The reinforcement of capacity of the gynecologists in minimally invasive technique for hysterectomies could reverse the curve.