Does surgical volume influence short-term outcomes of laparoscopic hysterectomy?

被引：42

作者：

Tunitsky, Elena ^{[1
]}

Citil, Ayse ^{[1
]}

Ayaz, Reyhan ^{[1
]}

Esin, Sertac ^{[1
]}

Knee, Alexander ^{[1
]}

Harmanli, Oz ^{[1
]}

机构：

[1] Tufts Univ, Sch Med, Dept Obstet & Gynecol, Baystate Med Ctr, Springfield, MA 01199 USA

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2010年 / 203卷 / 01期

关键词：

complications; conversion; hysterectomy; laparoscopic hysterectomy; learning curve; surgical volume; LEARNING-CURVE; COMPLICATIONS;

D O I：

10.1016/j.ajog.2010.01.070

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

OBJECTIVE: To evaluate whether surgical volume has an impact on short-term outcomes of laparoscopic hysterectomy. STUDY DESIGN: This is a retrospective analysis of 1016 laparoscopic hysterectomies. RESULTS: The surgeons were divided into 2 groups based on a cutoff of 30 cases. Patient characteristics, the rates of laparotomy (4.5% vs 6.7%), and serious complications (3.6% vs 5.5%) were similar between 9 "high" and the remaining 39 "low volume" gynecologists, respectively (P < .05). Mean operating time was longer in the "low volume" group. Compared with their first 29 hysterectomies, the "high volume" surgeons decreased their operating time significantly in their subsequent cases. The "high volume" surgeons improved their conversion rate (9.2% vs 2.4%; P < .0001) over time but not their serious complications. CONCLUSION: In laparoscopic hysterectomy, increasing the surgical volume can reduce the operating time and the risk for conversion to laparotomy but not the rate of serious complications.

引用

页码：24.e1 / 24.e6

页数：6

共 13 条

[1] Learning laparoscopic-assisted hysterectomy [J].

Altgassen, C ;

Michels, W ;

Schneider, A .

OBSTETRICS AND GYNECOLOGY, 2004, 104 (02) :308-313

[2] National learning curve for laparoscopic hysterectomy and trends in hysterectomy in Finland 2000-2005 [J].

Brummer, Tea H. R. ;

Seppala, Tomi T. ;

Harkki, Paivi S. M. .

HUMAN REPRODUCTION, 2008, 23 (04) :840-845

[3] Total laparoscopic hysterectomy: The Brisbane learning curve [J].

Garrett, Andrea J. ;

Nascimento, Marcelo Carraro ;

Nicklin, James L. ;

Perrin, Lewis C. ;

Obermair, Andreas .

AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY, 2007, 47 (01) :65-69

[4]

HAKKISIREN P, 1997, AM J OBSTET GYNECOL, V176, P118

[5]

Hanstede MME, 2009, J REPROD MED, V54, P193

[6] A comparison of short-term outcomes between laparoscopic supracervical and total hysterectomy [J].

Harmanli, Ozgur H. ;

Tunitsky, Elena ;

Esin, Sertac ;

Citil, Ayse ;

Knee, Alexander .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2009, 201 (05) :536.e1-536.e7

[7]

JOHNSON N, 2006, COCHRANE DB SYST REV, V19

[8] Complications of laparoscopic hysterectomy: comparison of the first 250 cases with the second 250 [J].

Jones, RA .

GYNAECOLOGICAL ENDOSCOPY, 2000, 9 (06) :373-378

[9]

Melendez T D, 1997, JSLS, V1, P45

[10]

OU CS, 1994, J AM ASS GYNECIOL LA, V1, pS33

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