title: Hysterectomies in Finland in 1990-2012: comparison of outcomes between trainees and specialists.
abstract: OBJECTIVE
  To assess trends for hysterectomy methods in the Nordic countries and to compare outcomes of hysterectomies in Finland done by trainees with those done by specialists.
  
  
  METHODS
  Register-based study.
  
  
  METHODS
  NOMESCO database for the Nordic countries and the Finnish Hospital Discharge Register.
  
  
  METHODS
  National prospective cohort of 5279 hysterectomies in Finland.
  
  
  METHODS
  Numbers of hysterectomies in the Nordic countries were collected in 1995-2011 and in Finland in 1990-2012. The Finhyst study to collect data on hysterectomies for benign indications was carried out in Finland in 2006. Information concerning patients, surgeons, and hysterectomy outcome was analysed.
  
  
  METHODS
  Hysterectomy numbers and methods. Operating time, blood loss, and complications in hysterectomies done by trainees and specialists.
  
  
  RESULTS
  In Finland, the rate of hysterectomies has been reduced by approximately 50% since the 1990s and is now similar to that in the other Nordic countries. The laparoscopic method is twice as common in Finland as in other Nordic countries, constituting 35-40% of all hysterectomies. The operating time for all hysterectomy methods was 16-25% longer among trainees than specialists. For the abdominal or laparoscopic methods there were no significant differences in the complication rates between the groups. In the vaginal approach, blood loss of ≥1000 mL was slightly more common in operations done by trainees (1.3% vs. 2.6%, p = 0.037).
  
  
  CONCLUSIONS
  Laparoscopic hysterectomy is more common in Finland than in the other Nordic countries. Although trainees need more time to operate, there were no differences between the trainees and the specialists with regard to major complication rates.
authors: Department of Obstetrics and Gynecology, Hospital District of Helsinki and Uusimaa/Hyvinkää Hospital, Hyvinkää, Finland.
authors: Ewa
authors: E
authors: Jokinen
authors: Department of Obstetrics and Gynecology, Østfold Central Hospital, Fredrikstad, Norway.
authors: Tea
authors: T
authors: Brummer
authors: Department of Obstetrics and Gynecology, Central Finland Central Hospital, Jyväskylä, Finland.
authors: Jyrki
authors: J
authors: Jalkanen
authors: Department of Obstetrics and Gynecology, North Karelia Central Hospital, Joensuu, Finland.
authors: Jaana
authors: J
authors: Fraser
authors: Terveystalo Private Healthcare Service, Kuopio, Finland.
authors: Anna-Mari
authors: AM
authors: Heikkinen
authors: Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.
authors: Juha
authors: J
authors: Mäkinen
authors: Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
authors: Jari
authors: J
authors: Sjöberg
authors: Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.
authors: Eija
authors: E
authors: Tomàs
authors: Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
authors: Tomi S
authors: TS
authors: Mikkola
authors: Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
authors: Päivi
authors: P
authors: Härkki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000453:epidemiology; D006176:Gynecology / Q000193:education; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007396:Internship and Residency / Q000706:statistics & numerical data; D010535:Laparoscopy / Q000706:statistics & numerical data; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries; D055815:Young Adult
keywords: Hysterectomy; complications; laparoscopic hysterectomy; surgical training; trainee