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  1. Subtotal hysterectomy in modern gynecology : A decision analysis. Discussion.

    Article, Communication - En anglais

    Annual Meeting of the Central Association of Obstetricians and Gynecologists. Houston, Texas (USA), 1996/10/17.

    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.

    Mots-clés Pascal : Hystérectomie, Subtotal, Indication, Critère décision, Intérêt, Risque, Carcinome, Col utérus, Faible, Analyse avantage coût, Homme, Femelle, Chirurgie, Appareil génital femelle pathologie, Utérus pathologie, Economie santé, Col utérus pathologie, Tumeur maligne

    Mots-clés Pascal anglais : Hysterectomy, Subtotal, Indication, Decision criterion, Interest, Risk, Carcinoma, Uterine cervix, Low, Cost benefit analysis, Human, Female, Surgery, Female genital diseases, Uterine diseases, Health economy, Uterine cervix diseases, Malignant tumor

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0380926

    Code Inist : 002B25K. Création : 12/09/1997.