FINHYST 2006--national prospective 1-year survey of 5,279 hysterectomies.
BACKGROUND
In Finland, the number of hysterectomies during one decade has decreased by 34%. The national prospective FINHYST study in 1996 showed abdominal hysterectomy (AH) as being most common: 58%. In Finland since 2002, vaginal hysterectomy (VH) has been most preferred, with laparoscopic hysterectomy (LH) surpassing AH in 2005.


METHODS
FINHYST 2006 is a national prospective hysterectomy study in which all hospitals collaborated from 1 January to 31 December 2006. Questionnaires, completed by gynaecologists, covered their experience, patient characteristics and surgical data.


RESULTS
The 5279 hysterectomies distributed by approaches were 44% VHs, 32% LHs and 24% AHs. Less than 2% were subtotal. The main indications for hysterectomy were myomas (33%), uterine prolapse (28%) and menorrhagia (21%). The main indication for VH was not related to uterine prolapse in 39%. Bilateral salpingo-ooforectomy was performed in 36% of AHs, 32% of LHs and 2% of VHs. Antibiotic prophylaxis was used in 97%, and thrombosis prophylaxis in 65%. Haemorrhage was least and operation time shortest with VH, and hospital stay and sick leave were shortest after LH.


CONCLUSIONS
In Finland, less invasive approaches comprise 76% of hysterectomies. This trend has resulted nationally in shortening of hospital stay and of convalescence time.
Brummer
Tea H I
TH
Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, PO Box 140, 00029 HUS, Helsinki, Finland. tea.brummer@hus.fi
Jalkanen
Jyrki
J
Fraser
Jaana
J
Heikkinen
Anna-Mari
AM
Kauko
Minna
M
Mäkinen
Juha
J
Puistola
Ulla
U
Sjöberg
Jari
J
Tomás
Eija
E
Härkki
Päivi
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005387:Finland / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods / Q000639:trends; D007902:Length of Stay; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D013927:Thrombosis / Q000517:prevention & control; D013997:Time Factors
D000900:Anti-Bacterial Agents