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Vaginal hysterectomy using electrofusion: a study of 96 cases
 

Vaginal hysterectomy using electrofusion: a study of 96 cases

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    Vaginal hysterectomy using electrofusion: a study of 96 cases Vaginal hysterectomy using electrofusion: a study of 96 cases Presentation Transcript

    • VAGINAL HYSTERECTOMY USING ELECTROFUSION: A STUDY OF 96 CASES Jean DUBUISSON Daniel RAUDRANT François GOLFIER Mona MASSOUD Hôtel Dieu – Lyon, France Centre Hospitalier Lyon-Sud, France
    • OBJECTIVE
      • To compare ligature by electrofusion vs. sutures in the practice of vaginal hysterectomy
    • METHOD
      • Retrospective study on 96 patients completed over a
      • period of 47 months (from april 2002 to februar 2006)
      • Inclusion :
          • Simple vaginal hysterectomy without concomitant
          • procedure and with the same technique
          • Under general anaesthesia
          • With or without salpingo-oophorectomy
          • ELECTROFUSION or SUTURE
    • RESULTS
      • 54 procedures in the suture-free group
              • 24 with LigaSure TM
              • 30 with BiClamp TM
      • 42 procedures in the suture control group
    • RESULTATS NS 167,5 ± 84,5 194,2 ± 116,5 weight of the postoperative specimen (grams) NS 0,12 ± 0,40 0,07 ± 0,43 Previous caesarean section NS 2,0 ± 1,2 2,0 ± 1,2 PARITY NS 48,4 ± 7,4 50,0 ± 9,4 AGE (years) p SUTURE (control group) N = 42 ELECTROFUSION N = 54
    • TYPE OF SURGERY RESULTS NS p 27 (43,5%) 35 (56,5%) Vaginal hysterectomies without salpingo-oophorectomy 15 (44,1%) 19 (55,9%) Vaginal hysterectomies with salpingo-oophorectomy SUTURE N = 42 ELECTROFUSION N = 54
    • MAIN INDICATIONS RESULTS NS p 3 (30,0%) 7 (70,0%) OTHERS 4 (28,6%) 10 (71,4%) Carcinologic pathology, cervical dysplasia 9 (52,9%) 8 (47,1%) ADENOMYOSIS 26 (47,3%) 29 (52,7%) FIBROID SUTURE N = 42 (%) ELECTROFUSION N = 54 (%)
    • RESULTS Post-operative pain evaluation <0,001 1,60 ± 0,96 0,94 ± 0,79 Associated analgesics <0,05 45,4 ± 51,3 22,4 ± 31,0 Cumulative doses (mg) <0,05 29,4 ± 18,8 22,4 ± 13,4 Timing of morphine administration (hours) <0,001 3,5 ± 2,3 1,9 ± 2,0 VAS MAX / 24h p SUTURE N = 42 ELECTROFUSION N = 54
    • RESULTS Comparison of operating time and hospitalization post-op <0,001 5,0 ± 1,0 4,2 ± 1,3 HOSPITALIZATION POST-OP (days) <0,001 67,6 ± 20,1 51,3 ± 22,6 OPERATING TIME (min) p SUTURE N = 42 ELECTROFUSION N = 54
      • ELECTROFUSION
      • 1 vaginal hemorrhage not requiring surgical intervention
      • 1 bladder injury
      • 1 conversion to laparotomy (deep infiltrating endometriosis)
      • SUTURE
      • 1 vaginal hemorrhage requiring surgical intervention
      • 1 bladder injury
      • 1 haematoma of the vault
      RESULTS Complications
    • CONCLUSION
      • ELECTROFUSION reduces significantly the operating time , postoperative pain and the duration of hospitalization without increasing the rate of perioperative complications . The use of electrofusion during vaginal surgery appears to be safe and simple. Moreover, it requires only minimal training in hands of experienced surgeons.
    •