Subtotal hysterectomy in modern gynecology: A decision analysis - 10/09/11
Abstract |
OBJECTIVE: Our purpose was to compare the risks and benefits of subtotal (supracervical) hysterectomy with those of total hysterectomy in women at low risk for cervical cancer.
STUDY DESIGN: A decision analysis was performed. Baseline probabilities for operative and postoperative morbidity, mortality, and long-term quality of life were established for subtotal and total hysterectomy.
RESULTS: Operative complication rates and ranges for total abdominal hysterectomy were infection 3.0% (3.0% to 20.0%), hemorrhage 2.0% (2.0% to 15.4%), and adjacent organ injury 1.0% (0.7% to 2.0%). Those for subtotal hysterectomy were infection 1.4% (1.0% to 5.0%), hemorrhage 2.0% (0.7% to 4.0%), and adjacent organ injury 0.7% (0.6% to 1.0%). Operative mortality, the risk for development of cervicovaginal cancer, and long-term adverse effects on sexual or vesicourethral function were low in both groups.
CONCLUSIONS: Recently proposed benefits from subtotal hysterectomy are not well proven. Total hysterectomy remains the procedure of choice for most women. (Am J Obstet Gynecol 1997;176:1186-92.)
Le texte complet de cet article est disponible en PDF.Keywords : Subtotal hysterectomy, decision analysis
Plan
From the Department of Obstetrics and Gynecology, University of Utah Medical Center. |
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Reprint requests: James R. Scott, MD, Department of Obstetrics and Gynecology, University of Utah Medical Center, Salt Lake City, UT 84132. |
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0002-9378/97 $5.00 + 0 16/6/81340 |
Vol 176 - N° 6
P. 1186-1192 - juin 1997 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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