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Mäkinen J, Brummer T, Jalkanen J, et al. Ten years of progress--improved hysterectomy outcomes in Finland 1996-2006: a longitudinal observation study. BMJ Open. 2013;3(10):e003169doi: 10.1136/bmjopen-2013-003169.
Mäkinen, J., Brummer, T., Jalkanen, J., Heikkinen, A. M., Fraser, J., Tomás, E., Härkki, P., & Sjöberg, J. (2013). Ten years of progress--improved hysterectomy outcomes in Finland 1996-2006: a longitudinal observation study. BMJ open, 3(10), e003169. https://doi.org/10.1136/bmjopen-2013-003169
Mäkinen, Juha, et al. "Ten years of progress--improved hysterectomy outcomes in Finland 1996-2006: a longitudinal observation study." BMJ open vol. 3,10 (2013): e003169. doi: https://doi.org/10.1136/bmjopen-2013-003169
Mäkinen J, Brummer T, Jalkanen J, Heikkinen AM, Fraser J, Tomás E, Härkki P, Sjöberg J. Ten years of progress--improved hysterectomy outcomes in Finland 1996-2006: a longitudinal observation study. BMJ Open. 2013 Oct 28;3(10):e003169. doi: 10.1136/bmjopen-2013-003169. PMID: 24165027; PMCID: PMC3816230.
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BMJ Open. 2013 Oct 28;3(10):e003169. doi: 10.1136/bmjopen-2013-003169.

Ten years of progress--improved hysterectomy outcomes in Finland 1996-2006: a longitudinal observation study.

BMJ open

Juha Mäkinen, Tea Brummer, Jyrki Jalkanen, Anna-Mari Heikkinen, Jaana Fraser, Eija Tomás, Päivi Härkki, Jari Sjöberg

Affiliations

  1. Department of Obstetrics and Gynecology, Turku University and Turku University Hospital, Turku, Finland.

PMID: 24165027 PMCID: PMC3816230 DOI: 10.1136/bmjopen-2013-003169

Abstract

OBJECTIVES: To study the outcome of various hysterectomies in 2 years 1996 (N =10110) and 2006 (N=5279). The hypothesis was that the change in operative practices in 10 years has resulted in improvements.

DESIGN: 2 prospective nationwide cohort evaluations with the same questionnaire.

SETTING: All national operative hospitals in Finland.

PARTICIPANTS: Patients scheduled to either abdominal hysterectomy (AH), vaginal hysterectomy (VH) or laparoscopic hysterectomy (LH) for benign disease.

OUTCOME MEASURES: Patients' characteristics, surgery-related details and complications (organ injury, infection, venous thromboembolism and haemorrhage).

RESULTS: The overall complication rates fell in LH and markedly in VH (from 22.2% to 11.7%, p<0.001). The overall surgery-related infectious morbidity decreased in all groups and significantly in VH (from 12.3% to 5.2%, p<0.001) and AH (from 9.9% to 7.7%, p<0.05). The incidence of bowel lesions in VH sank from 0.5% to 0.1% and of ureter lesions in LH from 1.1% to 0.3%. In 2006 there were no deaths compared with three in 1996.

CONCLUSIONS: The rate of postoperative complications fell markedly in the decade from 1996 to 2006. This parallels with the recommendation of the recent meta-analyses by Cochrane collaboration; the order of preference of hysterectomies was for the first time precisely followed in this nationwide study.

TRIAL REGISTRATION: The 2006 study was registered in the Clinical Trials of Protocol Registration System Data (NCT00744172).

Keywords: Gynaecology

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