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Predictive model for postpartum hemorrhage requiring hysterectomy in a minority ethnic region

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World Journal of Clinical Cases 2024年第22期12卷 4865-4872页

作者： Ling Wang Jun-Yu Pan Intensive Care Unit People's Hospital of Qiandongnan Miao and Dong Autonomous PrefectureKaili 556000Guizhou ProvinceChina

BACKGROUND Postpartum hemorrhage(PPH)is a leading cause of maternal mortality,and hysterectomy is an important intervention for managing intractable *** predicting the need for hysterectomy and taking proactive emergency measures is crucial for reducing mortality *** To develop a risk prediction model for PPH requiring hysterectomy in the ethnic minority regions of Qiandongnan,China,to help guide clinical *** The study included 23490 patients,with 1050 having experienced PPH and 74 who underwent *** independent risk factors closely associated with the necessity for hysterectomy were analyzed to construct a risk prediction model,and its predictive efficacy was subsequently *** The proportion of hysterectomies among the included patients was 0.32%(74/23490),representing 7.05%(74/1050)of PPH *** number of deliveries,history of cesarean section,placenta previa,uterine atony,and placenta accreta were identified in this population as independent risk factors for requiring a *** operating characteristic curve analysis of the prediction model showed an area under the curve of 0.953(95%confidence interval:0.928-0.978)with a sensitivity of 90.50%and a specificity of 90.70%.CONCLUSION The model demonstrates excellent predictive power and is effective in guiding clinical decisions regarding PPH in the ethnic minority regions of Qiandongnan,China.

关键词： Region Ethnicity Postpartum hemorrhage hysterectomy Risk factors Prediction

Vaginal natural orifice transluminal endoscopic total hysterectomy(vNOTES)

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Gynecology and Obstetrics Clinical Medicine 2024年第2期4卷 126-127页

作者： Ilnur Irekovich Musin Edvard Alexandrovich Berg Alfiya Galimovna Yashchuk Gulnaz Khanifovna Murtazina Danil Nikolaevich Ovsiuk Zarina Tagirovna Gimaeva Obstetrics and Gynecology Bashkir State Medical UniversityUfaRussia

A total hysterectomy is a common *** to published data,in the European Union,laparoscopic and laparoscopicassisted hysterectomies are performed more frequently than abdominal hysterectomies.A newtechnique in endoscopic surgery is the natural orifice approach-vaginal natural orifice transluminal endoscopic surgery(vNOTES).Performing a hysterectomy using the vNOTES method hasa numberofadvantages compared with the traditional one,including a decrease in the intensity of pain in the early postoperative period,the absence of a cosmeticdefect on the anterior abdominal wall and improved visualisation,which reduces the risk of intraoperative complications.

关键词： orifice hysterectomy endoscopic

Factors associated with surgical-site infection after total laparoscopic hysterectomy

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第4期5卷 131-135页

作者： Kosuke Shigematsu Koki Samejima Yuichirou Kizaki Shigetaka Matsunaga Tomonori Nagai Yasushi Takai Department of Obstetrics and Gynecology Saitama Medical CenterSaitama Medical UniversitySaitama 350-8550Japan

Objective:In recent years,minimally invasive surgery has been emphasized in gynecological surgery,and total laparoscopic hysterectomy has been increasingly *** this retrospective single-center study,the main objective was to identify risk factors for the development of surgical-site infection(SSI)after total laparoscopic *** secondary objective was to investigate the efficacy of transvaginal drainage as a treatment for ***:This retrospective study investigated 377 patients who underwent total laparoscopic hysterectomy in the Department of Obstetrics and Gynecology at the Saitama Medical Center,Saitama Medical University,Japan between January 1,2015 and December 31,*** were divided into the SSI group and non-SSI group based on whether they suffered from *** data of preoperative,intraoperative,and postoperative risk factors for SSI were collected and ***:Of the 377 patients who underwent total laparoscopic hysterectomy,21 patients were in the SSI group and 356 patients were in the non-SSI *** the comparison between the two groups and the multivariate analysis,only the C-reactive protein level on postoperative day 3(OR¼1.556,95%CI:1.233 e1.964,p7.6 mg/dL on postoperative day 3 could detect the SSI onset *** the SSI group,the hospital stay was longer for patients with transvaginal drainage than for patients without(17.40±3.21 d vs.10.90±2.39 d,p¼0.0027).However,none required ***:Patients with a high postoperative C-reactive protein level may be experiencing SSI,and ultrasonography and other imaging procedures should be performed *** a vaginal abscess is confirmed on imaging,transvaginal drainage should be performed early,which may prevent reoperation.

关键词： hysterectomy Laparoscopic surgery Surgical-site infection

Transvaginal natural orifice transluminal endoscopic surgery:A novel gasless technique to hysterectomy

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第1期5卷 35-39页

作者： Suyash Naval Shubhada Jajoo Rucha Naval Jayashri Rane Naval Multi Speciality Hospital M.J.College RoadNear Bhaskar MarketJalgaon 425001India Department of Obstetrics and Gynecology Jawaharlal Nehru Medical CollegeWardha 442107India

Transvaginal natural orifice transluminal endoscopic surgery(vNOTES),as a minimally invasive surgery technique,applies CO_(2) for creating pneumoperitoneum,and uses a closed system to through smoke evacuation from a dedicated outlet or *** has the potential to generate aerosol in the operation room,which can lead to an increased risk of transmission of *** technical note introduces a new technique of gasless pure vNOTES to hysterectomy using silicone face mask as a modified vNOTES port.

关键词： hysterectomy Natural orifice transluminal endoscopic surgery Transvaginal Gasless

hysterectomy in the Second Trimester of Pregnancy after In vitro Fertilization-embryo Transfer： A Case Report and Analysis of Its Risk Factors

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Chinese Medical Journal 2017年第4期130卷 490-491页

作者： Chan-Wei Jia Yan-Min Ma Shu-Yu Wang Reproductive Centre Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100026 China

In vitro fertilization-embryo transfer （IVF-ET） is an effective method and an elective procedure to treat infertility caused by various factors, for example, endometriosis, tubal obstruction, and polycystic ovary syndrome. However, this technique leads to a higher rate of complications and are therefore always iatrogenic such as ovarian hyperstimulation syndrome, thrombosis, multiple pregnancy, adnexal torsion, pelvic inflammatory disease （PID）, which may threaten fetal or maternal well-being during the whole pregnancy.

关键词： Disseminated Intravascular Coagulation Endometriosis hysterectomy In vitro Fertilization Septic Shock

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

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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

Treatment of uterine fibroid with triptorelin before hysterectomy

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Chinese Medical Journal 1998年第1期111卷 67-70页

作者： Loong EP Lo KW Chinese Univ Hong Kong Prince Wales Hosp Dept Obstet & Gynaecol Shatin NT Peoples R China

OBJECTIVE: To study the effects of pretreatment with triptorelin on uterine fibroid before abdominal hysterectomy. METHODS: Fifteen premenopausal Chinese women with symptomatic uterine fibroids requiring hysterectomy were recruited in the study. All patients received monthly intramuscular injections of 3.75 mg triptorelin for three months prior to abdominal hysterectomy. RESULTS: There was significant reduction in the serum levels of oestradiol (68.6%), progesterone (95.6%) and luteinizing hormone (73.9%) and in uterine (45.0%) and fibroid (68.0%) volumes. The serum level of follicle-stimulating hormone and haemoglobin concentration were not significantly different. CONCLUSIONS: Shrinkage of uterine fibroids can be achieved in women who are rendered hypoestrogenic with monthly injections of triptorelin for three months. This treatment modality may be of value prior to hysterectomy or myomectomy especially when the fibroid is large.

关键词： Adult Chemotherapy, Adjuvant Female Humans hysterectomy Injections, Intramuscular Leiomyoma Luteolytic Agents Middle Aged Preoperative Care Triptorelin Uterine Neoplasms

Comparison between microwave endometrial ablation and total hysterectomy

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Chinese Medical Journal 2006年第14期119卷 1195-1197页

作者： LIN Hua Department of Obstetrics and Gynaecology China-Japan Friendship Hospital Beijing 100029 China

Background Microwave endometrial ablation （MEA） is a new form of minimal invasive surgical procedure for menorrhagia. It has been widely adopted clinically in many countries. In this study, we compare the outcome of MEA and total hysterectomy for menorrhagia.Methods Sixty patients with menorrhagia were divided into MEA group or total hysterectomy （control） group （30 in each）. The intra operative blood loss, operating time, either preserving the uterus or not, and length of recovery time in the two groups were compared. The independent samples t test was used to analyse our data in the study. Results In comparing the MEA group and the control group, the effective rates were 96% （29/30） and 100% （30/30, χ^2 = 0, P = 1.0）. The operating time was （4.0± 1.1） minutes and （68.3±1.9） minutes （t =-160.42, P = 0.00）. The mean blood loss was 0 ml and 50 ml, respectively. Conclusions The curative effect of MEA is similar to that of total hysterectomy. When considering preservation of the uterus and postoperative recovery, MEA is obviously superior to total hysterectomy.

关键词： microwave endometrial ablation menorrhagia hysterectomy

Clinical assessment for three routes of hysterectomy

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Chinese Medical Journal 2009年第4期122卷 377-380页

作者： ZHU Lan LANG Jing-he LIU Chun-yan SHI Hong-hui SUN Zhi-jing FAN Rong Department of Obstetrics and Gynecology Peking Union MedicalCollege Hospital Chinese Academy of Medical Sciences & PekingUnion Medical College Beijing 100730 China

Background hysterectomy is a very common surgery in gynecology. Ideal surgery for hysterectomy is microinvasive with few complications. There are three major routes of hysterectomy that are currently used. The aim of this study was to identify the differences of peri-operative outcome among the patients who underwent the three different approaches.Methods One hundred and one women undergoing hysterectomy for myoma had the procedure performed by laparoscopic assisted vaginal hysterectomy （LAVH）, total vaginal hysterectomy （TVH） or total abdominal hysterectomy （TAH） in a randomized study. We compared the course of peri-operative and post-operative outcome for the three different approaches. Results were evaluated by linear regression analysis, Fisher＇s exact test and Student＇s t test for independent samples. Results The operation time among the three procedures was not significantly different （P 〉0.05）. The amount of blood loss in the TVH group was less than in the LAVH and TAH groups （P 〈0.05）. The pain score 3 hours after operation in the LAVH group was significantly lower than in the TAH and TVH groups （P 〈0.001）. The pain scores in the LAVH and TVH groups were lower than in the TAH group at 24 and 48 hours after operation （P 〈0.01）. The women who underwent LAVH and TVH had a shorter hospitalization stay （P 〈0.001）. The highest body temperature after operation in the TAH group was higher than that in LAVH and TVH groups （P 〈0.001）. Conclusions LAVH and TVH are better procedures for women requiring hysterectomy. The peri-operative and post-operative courses of TVH are better than LAVH, excluding the pain score 3 hours after operation. Vaginal hysterectomy is the most cost-effective approach but the final choice for the route of hysterectomy can depend on many factors such as gynecological disease, patients＇ health status and experiences of the gynecologist.

关键词： hysterectomy route outcome