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Advantages of nerve-sparing intrastromal total abdominal hysterectomy

Authors Samimi D, Allam A, Devereaux R, Han W, Monroe M

Published Date January 2013 Volume 2013:5 Pages 37—42


Received 27 October 2012, Accepted 11 December 2012, Published 22 January 2013

Video abstract presented by Daryoosh Samimi

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Daryoosh Samimi,1 Afdal Allam,2 Robert Devereaux,2 William Han,2 Mark Monroe2

1Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 2Department of Obstetrics and Gynecology, Fountain Valley Regional Hospital, Fountain Valley, CA, USA

Background: The purpose of the prospective study was to evaluate the effect of the nerve-sparing intrastromal abdominal hysterectomy bilateral salpingo-oophorectomy (ISTAH-BSO) on intraoperative, and postoperative complications namely blood loss and length of hospital stay.
Methods: Forty female patients were allocated by a block randomization method into a study group and a control group. The study group consisted of 20 patients who underwent ISTAH-BSO over a 2-year period. The control group included 20 patients who underwent conventional hysterectomy by the same surgeon during the same time frame. Both groups were followed for outcomes of interest, which included length of hospital stay, blood loss, and surgical complications. The participants in both groups were as similar as possible with respect to all known or unknown factors that might affect the study outcome.
Results: Postoperative hemoglobin levels were higher in the study group (blood loss 1.0 g/dL versus 1.4 g/dL in control group). Average hospital stay was significantly shorter in the study group (2.7 days versus 3.15 days in the control group, P = 0.028). No significant complications such as urinary fistula, vaginal vault prolapse, blood transfusion, or postoperative infections were identified in the study group.
Conclusion: The nerve-sparing ISTAH-BSO procedure described in this study has the potential to reduce length of hospital stay after abdominal hysterectomy by reducing blood loss and postoperative complications. Follow-up observations suggest that urinary function and sexual satisfaction are also preserved. Since this research, 175 cases have been performed, with an average of 5 years of follow-up. The outcomes of these cases have been reported as similar.

Keywords: cervical cancer, support system, nerve sparing, complications, blood loss, hospital stay

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