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Parametros pre, intra e pos-operatorios em mulheres submetidas a histerectomia vaginal na ausencia de prolapso uterino
Francisco Eduardo Prota
DATA DE PUBLICAÇÃO
Introduction: Vaginal hysterectomy represents the best performance procedure to the removal of the uterus, based on many evaluated factors, when compared to abdominal hysterectomy or even laparoscopic hysterectomy. Despite many well known advantages of vaginal hysterectomy, most surgeons among us only indicate it to women with prolapsed uterus, being very few those who indicate it to women with non prolapsed uterus. Objective: Evaluate pre, intra and post operative parameters from women eligible to vaginal hysterectomy with non prolapsed uterus Patients and Methods: This is retrospective study in which 190 medical records of women who underwent vaginal hysterectomy with non prolapsed uterus at Hospital e Maternidade Celso Pierro da PUC-Campinas and at the Hospital Penido Burnier during the period from march 2000 to september 2005 were reviewed. Women?s age, body mass index, parity, frequency of vaginal delivery, indication of hysterectomy, uterine volume through ultrasound, clinical history and previous pelvic surgeries were analyzed. In respect to the intra operatory procedures, types of anesthesia, surgical time, blood loss, technique used to remove the uterus, associated surgeries and complications were analyzed. The postoperative parameters analyzed were hospitalization period, histologic analysis of the removed organ, uterus weight and complications. Statistical analysis were done with frequency, means and standard deviation, using SAS version 8.2. Results: The mean age of women evaluated in this study was 44,6 years, with a mean body mass index of 26,4kg/m2; 91% of them with one or more gestation and 72.7% referred at least one cesarean section. The most frequent surgical indication was fibroid uterus 45.3% of the cases, followed by the diagnosis of dysfunctional uterine bleeding in 43.7%. The most frequent anesthesia was spinal and the amount of blood loss equal or greater than 300ml occurred in 11.6% of the cases. Operation time did not exceed 75 minutes in 58.9% of the cases. The distribution of techniques to reduce the uterine volume were similar. The frequency of intra and postoperative complications were low, 3.6% and 15.8%, respectively. The hospitalization time was less than 48 hours in 87.4% of the cases, and the mean hospital stay was 31.5 hours. Conclusions Complication rate, mean operation time, the amount of blood loss and the hospitalization period were low, which show that vaginal hysterectomy in non prolapsed uterus is a safe and advantageous procedure to many women