[Hysterectomy for benign lesions: what remains for the abdominal route?].
OBJECTIVE
We conducted a prospective study to assess what indications remain for abdominal hysterectomy for benign conditions.


METHODS
Four hundred fifty-three hysterectomies were performed for benign conditions between April 4, 1996 and December 14, 1998 in our unit. Abdominal hysterectomy was chosen for large uteri, when vaginal access was unusable, or in case of suspected post-operative pelvic adhesions.


RESULTS
We performed 330 vaginal hysterectomies (72.85%), 71 laparoscopy-assisted vaginal hysterectomies (15.6%) and 52 abdominal hysterectomies (11.4%). In 10 cases, laparoconversion was required when a vaginal or a laparoscopy-assisted hysterectomy was complicated by pelvic adhesions or poor vaginal access. Mean operative time for abdominal hysterectomy was 130 minutes and mean blood loss was 504 ml. Mean uterus weight was 612 g and mean hospital stay 6.4 days. We had 6 complications (11.53%) (one bladder injury, one ilial injury and four cases of intraoperative hemorrhage).


CONCLUSIONS
Our experience showed that the rate of complications is greater with laparoscopic hysterectomy due to patient selection and should be performed by trained surgeons.
Boukerrou
M
M
Hôpital Jeanne-de-Flandre, Clinique de Gynécologie, 2, avenue Oscar-Lambret, CHU Lille, 59037 Lille.
Lambaudie
E
E
Narducci
F
F
Crépin
G
G
Cosson
M
M
D000291:Adnexal Diseases / Q000150:complications; D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D005831:Genital Diseases, Female / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000379:methods* / Q000706:statistics & numerical data; D007045:Hysterectomy, Vaginal; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D013997:Time Factors; D000267:Tissue Adhesions / Q000150:complications; D014599:Uterus / Q000473:pathology