masterThesis
Resultados quirúrgicos de tres técnicas de histerectomía en patología ginecológica benigna, en el Hospital Universitario Mayor-Mederi
Fecha
2018Autor
Urbina Lastra, Jennifer Susana
Vargas Jimenez, Jessica
Institución
Resumen
Background: Hysterectomy is the most frequent surgical procedure performed in gynecology, the laparoscopy and open techniques intra and extrafascial are some of the most used techniques. The purpose of the present study was to compare the surgical results and the complications of total abdominal, intrafascial, extrafascial and laparoscopic hysterectomy in benign pathology in a university academic Hospital. Methodology: A retrospective cohort study was conducted at the Mayor Mederi University Hospital between January 2014 and January 2017, to compare three surgical hysterectomy techniques in terms of results and complications with a 15 day-follow up after the procedure was performed. Results: 831 hysterectomies were evaluated, 49.82% were extrafascial by laparotomy, 39.47% intrafascial by laparotomy and 10.71% intrafascial by laparoscopy. There are statistically significant differences in hospital stay between open techniques versus laparoscopic techniques pro open techniques (2.86±0.6 vs 2.39±0.3 days respectively p<0.001). Surgical time was shorter in open techniques versus laparoscopy (89.8±26 vs 113.9±36 min respectively p<0.001). Intraoperative bleeding was lower in laproscopy (235.5±216 vs 308.7±198cc respectivamente p<0.001), and the overall complication rate did not show significant differences when comparing the two open techniques, (12.07% vs 15.24% , p0.68), but there are significant differences when comparing open techniques with laparoscopy (27.31% vs 29.11% p0.01). Discussion: Laparoscopy offers better results in terms of intraoperative bleeding and hospital stay, with intraoperative complications, the need for transfusion and ICUs similar to open techniques; however, open techniques show fewer postoperative complications. On the other hand, among open techniques, extrasfascial offers better resultads in terms of hospital stay.