Tags

Type your tag names separated by a space and hit enter

Vaginal cuff dehiscence in a series of 12,398 hysterectomies: effect of different types of colpotomy and vaginal closure.
Obstet Gynecol. 2012 Sep; 120(3):516-23.OG

Abstract

OBJECTIVE

To investigate the risk of vaginal cuff dehiscence after different routes of hysterectomy and methods of cuff closure.

METHODS

A multi-institutional analysis of 12,398 patients who underwent hysterectomy for both benign and malignant disease between 1994 and 2008 was performed. We analyzed how different routes of hysterectomy and approaches to cuff suture may influence the risk of development of vaginal dehiscence.

RESULTS

Women who had total laparoscopic (n=3,573), abdominal (n=4,291), and vaginal (n=4,534) hysterectomies experienced 23 (0.64%), 9 (0.2%), and 6 (0.13%) cases of vaginal cuff dehiscence, respectively. Total laparoscopic hysterectomy was associated with a higher incidence of cuff separations, compared with abdominal hysterectomy (0.64% compared with 0.21%, P=.003) and vaginal hysterectomy (0.64% compared with 0.13%, P<.001). Within the endoscopic group, patients who underwent vaginal closure with laparoscopic knots had a higher rate of cuff dehiscence than patients who had suture with transvaginal knots (20 of 2,332 [0.86%] compared with 3 of 1,241 [0.24%], P=.028). When vaginal suture was performed transvaginally, no statistical difference in vaginal cuff dehiscence rate was observed compared with both abdominal hysterectomy (0.24% compared with 0.21%, P=.83) and vaginal hysterectomy (0.24% compared with 0.13%, P=.38). Use of monopolar energy at the time of colpotomy and reducing the power of monopolar energy from 60 watts to 50 watts when colpotomy was performed at the end of total laparoscopic hysterectomy did not alter the rate of cuff separations.

CONCLUSION

Transvaginal suturing appears to reduce the risk of vaginal dehiscence after total laparoscopic hysterectomy.

Links

Aggregator Full Text

Authors+Show Affiliations

Uccella S
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy. stefucc@libero.it
Ceccaroni M
No affiliation info available
Cromi A
No affiliation info available
Malzoni M
No affiliation info available
Berretta R
No affiliation info available
De Iaco P
No affiliation info available
Roviglione G
No affiliation info available
Bogani G
No affiliation info available
Minelli L
No affiliation info available
Ghezzi F
No affiliation info available

MeSH

AdultAgedAged, 80 and overColpotomyFemaleFollow-Up StudiesHumansHysterectomyHysterectomy, VaginalIncidenceLaparoscopyMiddle AgedRetrospective StudiesSurgical Wound DehiscenceSuture TechniquesTreatment Outcome

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

22914459

Clinical Trial Links

Vaginal Cuff Dehiscence Following Total Laparoscopic Hysterectomy: Laparoscopic vs. Transvaginal Cuff Closure
Barbed vs Standard Suture for Laparoscopic Vaginal Cuff Closure

Citation

Uccella, Stefano, et al. "Vaginal Cuff Dehiscence in a Series of 12,398 Hysterectomies: Effect of Different Types of Colpotomy and Vaginal Closure." Obstetrics and Gynecology, vol. 120, no. 3, 2012, pp. 516-23.
Uccella S, Ceccaroni M, Cromi A, et al. Vaginal cuff dehiscence in a series of 12,398 hysterectomies: effect of different types of colpotomy and vaginal closure. Obstet Gynecol. 2012;120(3):516-23.
Uccella, S., Ceccaroni, M., Cromi, A., Malzoni, M., Berretta, R., De Iaco, P., Roviglione, G., Bogani, G., Minelli, L., & Ghezzi, F. (2012). Vaginal cuff dehiscence in a series of 12,398 hysterectomies: effect of different types of colpotomy and vaginal closure. Obstetrics and Gynecology, 120(3), 516-23. https://doi.org/10.1097/AOG.0b013e318264f848
Uccella S, et al. Vaginal Cuff Dehiscence in a Series of 12,398 Hysterectomies: Effect of Different Types of Colpotomy and Vaginal Closure. Obstet Gynecol. 2012;120(3):516-23. PubMed PMID: 22914459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaginal cuff dehiscence in a series of 12,398 hysterectomies: effect of different types of colpotomy and vaginal closure. AU - Uccella,Stefano, AU - Ceccaroni,Marcello, AU - Cromi,Antonella, AU - Malzoni,Mario, AU - Berretta,Roberto, AU - De Iaco,Pierandrea, AU - Roviglione,Giovanni, AU - Bogani,Giorgio, AU - Minelli,Luca, AU - Ghezzi,Fabio, PY - 2012/8/24/entrez PY - 2012/8/24/pubmed PY - 2012/10/30/medline SP - 516 EP - 23 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 120 IS - 3 N2 - OBJECTIVE: To investigate the risk of vaginal cuff dehiscence after different routes of hysterectomy and methods of cuff closure. METHODS: A multi-institutional analysis of 12,398 patients who underwent hysterectomy for both benign and malignant disease between 1994 and 2008 was performed. We analyzed how different routes of hysterectomy and approaches to cuff suture may influence the risk of development of vaginal dehiscence. RESULTS: Women who had total laparoscopic (n=3,573), abdominal (n=4,291), and vaginal (n=4,534) hysterectomies experienced 23 (0.64%), 9 (0.2%), and 6 (0.13%) cases of vaginal cuff dehiscence, respectively. Total laparoscopic hysterectomy was associated with a higher incidence of cuff separations, compared with abdominal hysterectomy (0.64% compared with 0.21%, P=.003) and vaginal hysterectomy (0.64% compared with 0.13%, P<.001). Within the endoscopic group, patients who underwent vaginal closure with laparoscopic knots had a higher rate of cuff dehiscence than patients who had suture with transvaginal knots (20 of 2,332 [0.86%] compared with 3 of 1,241 [0.24%], P=.028). When vaginal suture was performed transvaginally, no statistical difference in vaginal cuff dehiscence rate was observed compared with both abdominal hysterectomy (0.24% compared with 0.21%, P=.83) and vaginal hysterectomy (0.24% compared with 0.13%, P=.38). Use of monopolar energy at the time of colpotomy and reducing the power of monopolar energy from 60 watts to 50 watts when colpotomy was performed at the end of total laparoscopic hysterectomy did not alter the rate of cuff separations. CONCLUSION: Transvaginal suturing appears to reduce the risk of vaginal dehiscence after total laparoscopic hysterectomy. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/22914459/Vaginal_cuff_dehiscence_in_a_series_of_12398_hysterectomies:_effect_of_different_types_of_colpotomy_and_vaginal_closure_ L2 - https://doi.org/10.1097/AOG.0b013e318264f848 DB - PRIME DP - Unbound Medicine ER -