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Total laparoscopic hysterectomy: The Brisbane learning curve
Author(s) -
GARRETT Andrea J.,
NASCIMENTO Marcelo Carraro,
NICKLIN James L.,
PERRIN Lewis C.,
OBERMAIR Andreas
Publication year - 2007
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2006.00682.x
Subject(s) - medicine , laparotomy , tertiary referral hospital , blood loss , hysterectomy , surgery , retrospective cohort study , laparoscopy , tertiary referral centre , general surgery , referral , gynaecological cancer , cancer , family medicine
Abstract Background: Total laparoscopic hysterectomy (TLH) is becoming more commonly used for gynaecological malignancies. Aims: To describe our experience with TLH since its introduction to our tertiary referral centre for gynaecological cancer in 2003. Methods: Retrospective analysis of the first 120 consecutive cases of TLH performed at our gynaecological cancer centre. Patients were divided into the first, second and third group of 40 patients. Operating time, estimated blood loss, hospital stay, conversion to laparotomy and intra‐ and postoperative morbidity were evaluated. Results: The three groups were similar with regard to baseline characteristics. For the entire group the mean hospital stay was 2.4 ± 1.4 days and eight of 120 patients (6.6%) required conversion to laparotomy. Operating time, estimated blood loss and intraoperative morbidity were similar among the three groups. Postoperative morbidity was highest (25%) in the middle one‐third of the patients ( P = 0.022). The percentage of pelvic lymph node dissections increased from 2.5% in the first one‐third of patients to 27.5% in the final one‐third of patients ( P = 0.003). Conclusions: TLH can be established safely in a tertiary gynaecological cancer referral centre.