title: Usefulness of vessel-sealing devices for peripartum hysterectomy: a retrospective cohort study.
abstract: To evaluate the feasibility to perform peripartum hysterectomy (PH) with the introduction of LigaSure™ vessels-sealing device (LVSD) and how it influenced the surgical outcomes. We retrospectively evaluated procedures and outcome of women undergoing PH during the period between January 2001 and October 2013. Perioperative surgical results of patients undergoing PH using LVSD were compared to patients undergoing PH without LVSD. Forty-nine subjects had PH during the study period. Twenty (41%) hysterectomies were performed for placenta accreta, 8 (16%) for placenta previa, 21 (43%) for atony. Twenty-three subjects had PH using LVSD and 26 subjects had hysterectomy without the use of this device. We observe significant differences in estimated blood loss (p = 0.001), massive blood transfusions (>10 units RBC) (p = 0.025), operative time (p = 0.06). No difference in term of hospital stay and complications were observed (p = 0.78 and p = 0.35). One patient for each group had intraoperative complication (p = 0.9). The use of LVSD during PH does not increase operative complications, blood loss, and operative time in comparison to standard procedure.
authors: Department of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors: Diego
authors: D
authors: Rossetti
authors: Salvatore Giovanni
authors: SG
authors: Vitale
authors: Giorgio
authors: G
authors: Bogani
authors: Agnese Maria Chiara
authors: AM
authors: Rapisarda
authors: Ferdinando Antonio
authors: FA
authors: Gulino
authors: Luigi
authors: L
authors: Frigerio
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D007431:Intraoperative Complications; D007902:Length of Stay; D061646:Operative Time; D058725:Peripartum Period; D010921:Placenta Accreta / Q000601:surgery; D010923:Placenta Previa / Q000601:surgery; D011247:Pregnancy; D012189:Retrospective Studies; D014593:Uterine Inertia / Q000601:surgery; D065506:Vascular Closure Devices