Laparoscopically assisted vaginal hysterectomy in a university hospital: report of 82 cases and comparison with abdominal and vaginal hysterectomy

Article Abstract:

A review of the records of 82 women who had laparoscopically assisted vaginal hysterectomies found that patient recovery is quicker and that the complication rate is midway between that of abdominal and vaginal hysterectomy. A laparoscope is a thin tube that when inserted through the abdomen allows examination of the ovaries and fallopian tubes. A hysterectomy is performed to remove the uterus and sometimes the ovaries. The laparoscope was most often used in cases where the ovaries were also removed. Complications occurred in 26% of the 354 patients who had abdominal hysterectomy, 12% of those who had laparoscopically assisted vaginal procedures and 6% of the 73 who had vaginal hysterectomies. The cost of the laparoscopically assisted procedure is significantly higher than the cost of the other procedures. This is attributed to longer operating time and the use of disposable equipment.

Methods, Surgery

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The medical and economic impact of laparoscopically assisted vaginal hysterectomy in a large, metropolitan, not-for-profit hospital

Article Abstract:

Vaginal hysterectomy assisted by laparoscopy may be a safe and less expensive replacement to traditional abdominal hysterectomy. Researchers conducted a retrospective analysis of 2563 hysterectomies performed by 37 gynecologists during a three year period. The percentage of abdominal hysterectomies dropped from 65% at the beginning six months of the study period to 36% during the last six months. The percentage of laparoscopically assisted vaginal hysterectomies (LAVH) rose from 12% to 45%, while the rate of plain vaginal hysterectomies remained about the same at 23% to 19%. Postoperative fever was the most common complication of abdominal hysterectomy. LAVH resulted in a day shorter hospital stay, longer operating time, and reduced cost over abdominal hysterectomies.

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Single-agent methotrexate chemotherapy for the treatment of nonmetastatic gestational trophoblastic tumors

Article Abstract:

Methotrexate chemotherapy for treating nonmetastatic tumors of embryonic tissue proved effective and was well tolerated. From 1962 through 1990, 337 patients with nonmetastatic invasive mole or choriocarcinoma were treated at Northwestern University Medical School. All were cured. Among the group, 75% were initially treated with methotrexate. Of these, 27 patients, or 11%, developed resistance and required an additional chemotherapeutic agent. Of these, 22 responded with the addition of actinomycin D, 3 required multiagent therapy, and 2 required a hysterectomy for complete cure. Only 12 patients, or 5%, required a change in agent due to toxic reaction. None were life-threatening. The most common toxic reaction was severe mouth inflammation.

Drug therapy, Methotrexate, Trophoblastic tumors

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