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Comparison of surgical indications for hysterectomy by age and approach in 4653 Chinese women

Frontiers of Medicine 2014年第4期8卷 464-470页

作者： Jingjing Jiang Ting Ding Aiyue Luo Yunping Lu Ding Ma Shixuan Wang Department of Obstetrics and Gynecology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China

Approximately one million hysterectomies are performed each year in China. However, national data regarding the indications and the surgical approaches for hysterectomy are lacking. The aim of this study was to examine the surgical indications for hysterectomy in different age groups and the relative merits of different surgical approaches for hysterectomy in Chinese women. Clinical data from 4653 cases of hysterectomy performed in Tongji Hospital from 2004 to 2009 were analysed. Hysterectomy was most commonly performed among women aged 40-49 years （2299; 49.4%）. Overall, colporrhagia and abdominal pain were the two most common indications for hysterectomy. The most common indications by age groups were as follows： malignant ovarian tumour, 〈 20 years; malignant uterine tumour, 20-29 and 30-39 years; uterine myoma, 40-49 and 50-59 years; and uterine prolapse, 60-69 and 〉 70 years. The proportion of malignant aetiology also varied by age, being the highest in women aged 〈 20 years （75.0%） and the lowest in those aged 40-49 years （19.9%）. Approximately 35% women who had hysterectomies also had concomitant bilateral oophorectomy. The lowest rate of oophorectomy occurred in women aged 30-39years （15.8%）, whereas the highest rate was in those aged 50-59years （75.9%）. The abdominal surgical approach was used in 84% of all hysterectomies. Surgeries using the vaginal approach required a significantly shorter operating time （118 min average） than all other approaches （P 〈 0.05）. Both the amount of bleeding and the blood transfusion volume required were smaller in vaginal approaches, with no significant differences between the others. The surgical approaches used were also related to the scope of surgery. Both the surgical indications and the rates of bilateral oophorectomy varied by age. In terms of both operating time and the amount of bleeding and blood transfusion volume required, the vaginal approach was superior to all other surgical approaches.

关键词： hysterectomy surgical indications surgical approach bilateral oophorectomy

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surgical Management of Abdominal Trauma: indications and Outcomes in Two Emergency Units with Limited Infrastructure Resources in Yaoundé(Cameroon)

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surgical Science 2021年第10期12卷 339-349页

作者： Savom Eric Patrick Bang Guy Aristide Biwole Biwole Daniel Bitang A. Mafok Louis Joss Bwelle Motto Georges Roger Ekani Boukar Mahamat Yannick Ngo Nonga Bernadette Essomba Arthur Yaoundé General Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Yaoundé Teaching Hospital Yaoundé Cameroon Yaoundé Central Hospital Yaoundé Cameroon Yaoundé Emergency Centre Yaoundé Cameroon Faculty of Health Sciences University of Buea Yaoundé Cameroon

Introduction: Abdominal trauma is a major public health concern. Their management is controversial and difficult. Operative indications are not codified in all situations. Patients and Methods: This was a descriptive cross- sectional study over a period of 5 years, carried out in the surgical emergency department of the Central Hospital of Yaoundé and the Emergency Centre of Yaoundé. We reviewed retrospectively medical records of patients who had laparotomy after abdominal trauma. Results: We collected 115 files. There was a male predominance (83.47%) and the average age was 33.8 years. The average time to admission was 12.3 hours and the aetiologies were dominated by road traffic accidents (53%). Abdominal contusions represented 69.56% of cases and abdominal wounds 30.44% of cases. Indications for surgery were hemodynamic instability, evidence of a lesion of a hollow viscus, the presence of evisceration or a gunshot wound, and initial non-operative treatment failure. Postoperative morbidity was 9.56% and overall mortality was 3.47%. Conclusion: surgical management of abdominal trauma is frequent in our setting, mainly indicated for hem

关键词： Abdominal Trauma Abdominal Contusion Abdominal Wound surgical indications Yaoundé

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Clinical literature review of the surgery of 1858 CD cases in China(1990-2013)

Clinical literature review of the surgery of 1858 CD cases i...

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第十七届西南地区消化病学术会议暨2014贵州省消化病及...

作者： Peng Qing-hai Departments of Gastroenterology West China HospitalSichuan University

Objective:To summarize the characteristics of the surgery of CD in ***:We searched four Chinese databases:CBM,VEP,CNKI,Wan *** we selected and read 97 literatures carefully,and extracted the clinical data about the surgery of ***:We found that 1858 CD cases went for *** major disease location were ileum(40.84%),followed with colon(33.60%)and ileum and colon(23.09%).The surgical reasons include intestinal obstruction or stricture(23.84%),medical failure(around 15%),acute abdominal diseases(13.46%),abdominal mass(10.93%),intestinal fistulae(9.90%),intestinal perforation(8.45%),perianal diseases(6.73%),gastrointestinal bleeding(4.79%),abdominal abscess(4.04%);the diagnosis of CD before surgery was low(34.78%).A total of 317 cases was misdiagnosed,the misdiagnosis diseases before surgery included acute appendicitis(49.21%),intestinal tumor(29.02%),intestinal tuberculosis(11.36%),and ulcerative colitis(10.41%).The major surgical procedure of CD were bowel resection and among the cases of the colonic resection,approximately 99%patients were in partial colonic resection;the rate of surgical complications was 20.34%,the primary complication for surgery was infection(39.44%),then were intestinal fistulae(26.09%),death(surgery-related)(18.63%),stricture or obstruction(12.11%),intestinal adhesion(3.41%),abdominal abscess(4.34%),gastrointestinal bleeding(4.03%),stress ulcer(2.80%).From the follow-up results,the remission or effective rate of CD after surgery was 72.29%,and the relapse rate after surgery was 23.94%.Conclusion:The surgery clinical characteristics of CD in China are generally similar to the west,with a little *** rate of surgery complications and misdiagnosis are higher than these of the west,while the rate of CD complicated with tumor,the surgery rate,and the relapse rate are relatively lower in China.

关键词： Crohn’s disease surgery surgical complications surgical reasons operation surgical indications surgical recurrence relapse

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