Usefulness of vessel-sealing devices for peripartum hysterectomy: a retrospective cohort study

被引:25
作者
Rossetti D. [1 ]
Vitale S.G. [2 ]
Bogani G. [3 ]
Rapisarda A.M.C. [2 ]
Gulino F.A. [2 ]
Frigerio L. [1 ]
机构
[1] Department of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo
[2] Department of Medical Surgical Specialties, University of Catania, Via Santa Sofia 78, Catania
[3] Department of Obstetrics and Gynecology, University of Insubria, Varese
关键词
Complications; LigaSure™; Massive blood transfusions; Operative time; Peripartum hysterectomy; Vessels-sealing device;
D O I
10.1007/s13304-015-0289-0
中图分类号
学科分类号
摘要
To evaluate the feasibility to perform peripartum hysterectomy (PH) with the introduction of LigaSure™ vessels-sealing device (LVSD) and how it influenced the surgical outcomes. We retrospectively evaluated procedures and outcome of women undergoing PH during the period between January 2001 and October 2013. Perioperative surgical results of patients undergoing PH using LVSD were compared to patients undergoing PH without LVSD. Forty-nine subjects had PH during the study period. Twenty (41 %) hysterectomies were performed for placenta accreta, 8 (16 %) for placenta previa, 21 (43 %) for atony. Twenty-three subjects had PH using LVSD and 26 subjects had hysterectomy without the use of this device. We observe significant differences in estimated blood loss (p = 0.001), massive blood transfusions (>10 units RBC) (p = 0.025), operative time (p = 0.06). No difference in term of hospital stay and complications were observed (p = 0.78 and p = 0.35). One patient for each group had intraoperative complication (p = 0.9). The use of LVSD during PH does not increase operative complications, blood loss, and operative time in comparison to standard procedure. © 2015, Italian Society of Surgery (SIC).
引用
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页码:301 / 304
页数:3
相关论文
共 14 条
[1]  
Sinha R., Roxby D., Bersten A., Experience with a massive transfusion protocol in the management of massive haemorrhage, Transfus Med, 23, pp. 108-113, (2013)
[2]  
Wei Q., Zhang W., Chen M., Zhang L., He G., Liu X., Peripartum hysterectomy in 38 hospitals in China: a population-based study, Arch Gynecol Obstet, 289, pp. 549-553, (2013)
[3]  
Castaneda S., Karrison T., Cibils L.A., Peripartum hysterectomy, J Perinat Med, 28, pp. 472-481, (2000)
[4]  
Hudon L., Belfort M.A., Broome D.R., Diagnosis and management of placenta percreta: a review, Obstet Gynecol Surv, 53, pp. 509-517, (1998)
[5]  
Gizzo S., Burul G., Di Gangi S., Lamparelli L., Saccardi C., Nardelli G.B., D'Antona D., LigaSure vessel sealing system in vaginal hysterectomy: safety, efficacy and limitations, Arch Gynecol Obstet, 288, pp. 1067-1074, (2013)
[6]  
Aydin C., Yildiz A., Kasap B., Yetimalar H., Kucuk I., Soylu F., Efficacy of electrosurgical bipolar vessel sealing for abdominal hysterectomy with uterine myomas more than 14 weeks in size: a randomized controlled trial, Gynecol Obstet Invest, 73, pp. 326-329, (2012)
[7]  
Janssen P.F., Brolmann H.A., van Kesteren P.J., Bongers M.Y., Thurkow A.L., Heymans M.W., Huirne J.A., Perioperative outcomes using LigaSure compared with conventional bipolar instruments in laparoscopic hysterectomy: a randomised controlled trial, BJOG, 118, pp. 1568-1575, (2011)
[8]  
Bateman B.T., Mhyre J.M., Callaghan W.M., Kuklina E.V., Peripartum hysterectomy in the United States: nationwide 14 year experience, Am J Obstet Gynecol, 206, 63, pp. e1-e8, (2012)
[9]  
Fawcus S., Moodley J., Postpartum haemorrhage associated with caesarean section and caesarean hysterectomy, Best Pract Res Clin Obstet Gynaecol, 27, pp. 233-249, (2013)
[10]  
Zelop C.M., Harlow B.L., Frigoletto F.D., Safon L.E., Saltxman D.H., Emergency peripartum hysterectomy, Am J Obstet Gynecol, 168, pp. 1443-1448, (1993)