Hysterektomi ved St. Olavs hospital 1989–2014
Sammanfattning
BACKGROUND: Hysterectomy is one of the most frequently performed gynaecological procedures, for which surgical methods have changed in recent decades. New possibilities for assessment and alternative treatment methods have appeared. The purpose of this study is to describe the developments in hysterectomy performed for benign indications at St. Olavs Hospital in the period 1989–2014.
MATERIAL AND METHOD: Altogether 903 patients were included from the years 1989, 1994, 1999, 2004, 2010 and 2014. Information from patient records on demography, preoperative assessment and treatment, surgical indication, surgical method, complications, period of hospitalisation and period of sickness absence were recorded retrospectively by reviewing patient records.
RESULTS: From 1989 to 2014, preoperative diagnosis by dilation and curettage was reduced from 68 % to 4 %, whereas the Pipelle method increased from 8 % to 68 %. In 2014, ultrasound examination was performed in 97 % of patients. While hysterectomies performed with laparotomy fell from 107 in 1989 to 37 per 100 000 women in 2014, vaginal and laparoscopic hysterectomies together increased in the same period from three to 81 per 100 000 women. In 2014, almost half of hysterectomies were performed with robot-assisted laparoscopy. In parallel with the transition from laparotomy to less invasive methods, less bleeding was recorded as well as shorter periods of hospitalization and sickness absence.
INTERPRETATION: Surgical methods for hysterectomies have shifted from open laparotomy to less invasive methods such as vaginal and laparoscopic surgery. Robot-assisted laparoscopic hysterectomy is now the most common surgical method. Less invasive procedures are favourable for patient safety and recovery.