title: [Indications and surgical technique of subtotal hysterectomy for a general surgeon practicing in austere environment with limited resources].
abstract: Uterine fibromyomata in Africa, which represents the most frequent benign uterine disease, is a real public health. This pathology is frequent and most of times discovered at a late stage where the volume of the uterus is responsible for invalidating symptoms that impairs patients' quality of life. Subtotal hysterectomy, which preserves the cervix, is faster than total hysterectomy and reduces intraoperative (duration of operation, blood loss) and postoperative morbidity (urinary infection, vaginal cicatrization). Subtotal hysterectomy is adapted to countries with limited resources. Its realization requires the preoperative assessment of normal cervix and a regular post-operative follow-up of the cervix left in place.
authors.affiliation: Service de chirurgie viscérale et générale, hôpital d'instruction des Lavéran, 34, boulevard Laveran, Marseille, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Goudard
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier intercommunal de Créteil, France.
authors.forename: V
authors.initials: V
authors.lastname: Canel
authors.affiliation: Service de chirurgie viscérale et générale, hôpital d'instruction des Lavéran, 34, boulevard Laveran, Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Goin
authors.affiliation: Service de chirurgie viscérale et générale, hôpital d'instruction des Lavéran, 34, boulevard Laveran, Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Pauleau
authors.affiliation: Service de chirurgie urologique, hôpital d'instruction des armées Sainte-Anne, Toulon, France.
authors.forename: P-H
authors.initials: PH
authors.lastname: Savoie
authors.affiliation: Service de chirurgie viscérale et générale, hôpital d'instruction des armées Percy, 101 av. Henri Barbusse, BP 406, 92141 Clamart Cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Hornez
authors.affiliation: Service d'anesthésie-réanimation, hôpital d'instruction des armées Sainte-Anne, Toulon, France.
authors.forename: J
authors.initials: J
authors.lastname: Bordes
authors.affiliation: Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Desgenettes, Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Bertani
authors.affiliation: Service de chirurgie viscérale et générale, hôpital d'instruction des Lavéran, 34, boulevard Laveran, Marseille, France, Service de chirurgie viscérale et générale, hôpital d'instruction des armées Sainte-Anne, Toulon, France.
authors.forename: P
authors.initials: P
authors.lastname: Balandraud
authors.affiliation: Service de chirurgie viscérale et générale, hôpital d'instruction des armées Percy, 101 av. Henri Barbusse, BP 406, 92141 Clamart Cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Bonnet
mesh_terms: D005260:Female; D013502:General Surgery; D006295:Health Resources; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D011203:Poverty; D017410:Practice Guidelines as Topic; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Africa; benign gynaecologic disease; limited resources; subtotal hysterectomy; surgery; uterine fibroids