Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 4 , Pages 400-402, December 2009

Surgical Blood Loss and Laparoscopic-Assisted Vaginal Hysterectomy

  • Wei-Chien Wu

      Affiliations

    • Department of Obstetrics and Gynecology, China Medical University and Hospital, Taichung, Taiwan
    • ,
  • Ching-Hung Hsieh

      Affiliations

    • Department of Obstetrics and Gynecology, Clinic of Fu Jen Catholic University, Taipei, Taiwan
    • ,
  • Li-Chia Huang

      Affiliations

    • Department of Obstetrics and Gynecology, China Medical University and Hospital, Taichung, Taiwan
    • ,
  • Yin-Yi Chang

      Affiliations

    • Department of Obstetrics and Gynecology, China Medical University and Hospital, Taichung, Taiwan
    • ,
  • Yao-Ching Hung

      Affiliations

    • Department of Obstetrics and Gynecology, China Medical University and Hospital, Taichung, Taiwan
    • ,
  • Wei-Chun Chang

      Affiliations

    • Department of Obstetrics and Gynecology, China Medical University and Hospital, Taichung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Wei-Chun Chang, Department of Obstetrics and Gynecology, China Medical University and Hospital, 2, Yuh-Der Road, Taichung 404, Taiwan

Accepted 10 February 2009.

Article Outline

Summary 

Objective

This study aimed to elucidate the possible relationship between surgical blood loss (SBL) and medical outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH).

Materials and Methods

Patients who underwent LAVH performed by the same surgeon for benign gynecologic diseases from 2004 to 2006 were analyzed retrospectively. Patients were divided into two groups according to the amount of SBL (< 150 mL or ≥ 150 mL, 75th percentile of mean SBL). Clinical medical outcomes of all women were analyzed to identify the effects of SBL during LAVH.

Results

A total of 133 women with benign gynecologic disease were included. Group 1 (SBL < 150 mL) consisted of 108 patients and Group 2 (SBL≥ 150 mL) consisted of 25 patients. The mean operative time for patients with SBL≥ 150 mL was 36.1 minutes longer than that for patients with SBL < 150 mL (p < 0.001). Mean hospital stay, mean shift in serum hemoglobin, mean shift in serum hematocrit and mean flatulence relief time were not significantly different between the two groups.

Conclusion

Greater SBL (≥ 150 mL) during LAVH was significantly associated with longer operating time, but had no detrimental effect on short-term surgical outcomes. Thus, efforts to minimize intraoperative bleeding and so reduce operative time will be beneficial for women undergoing LAVH.

Key Words:  hysterectomy , laparoscopic , operation time , quality indicator , robotic surgery , surgical blood loss

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Reich HJ , DeCaprio J , McGlynn F . Laparoscopic hysterectomy . J Gynecol Surg . 1989;5:213–216
  2. Reich H , Roberts L . Laparoscopic hysterectomy in current gynecological practice . Rev Gynecol Pract . 2003;3:32–40
  3. Sinha R , Sundaram M , Nikam YA , Hegde A , Mahajan C . Total laparoscopic hysterectomy with earlier uterine artery ligation . J Minim Invasive Gynecol . 2008;15:355–359
  4. Nezhat F , Nezhat C , Gordon S , Wilkins E . Laparoscopic versus abdominal hysterectomy . J Reprod Med . 1992;37:247–250
  5. Moir DD . Blood loss during major vaginal surgery: a statistical study of the influence of general anaesthesia and epidural analgesia . Br J Anaesth . 1968;40:233–240
  6. Zheng F , Cammisa FP , Sandhu HS , Girardi FP , Khan SN . Factors predicting hospital stay, operative time, blood loss, and transfusion in patients undergoing revision posterior lumbar spine decompression, fusion, and segmental instrumentation . Spine . 2002;27:818–824
  7. Chang WC , Li TC , Lin CC . The effect of physician experience on costs and clinical outcomes of laparoscopic-assisted vaginal hysterectomy: a multivariate analysis . J Am Assoc Gynecol Laparosc . 2003;10:356–359
  8. Farquhar CM , Steiner CA . Hysterectomy rates in the United States 1990–1997 . Obstet Gynecol . 2002;99:229–234
  9. Pitter MC , Anderson P , Blissett A , Pemberton N . Robotic-assisted gynaecological surgery-establishing training criteria; minimizing operative time and blood loss . Int J Med Robot . 2008;4:114–120

PII: S1028-4559(09)60330-2

doi:10.1016/S1028-4559(09)60330-2

Taiwanese Journal of Obstetrics and Gynecology
Volume 48, Issue 4 , Pages 400-402, December 2009

Article Tools