RESUMO
Objetivo: describir los resultados posquirúrgicos de la histerectomía vaginal sin prolapso uterino. Materiales y métodos: estudio de cohorte de pacientes, a quienes se les practicó histerectomía vaginal sin prolapso (HSVP) por patología benigna uterina, utilizando la técnica de Heaney modificada y técnicas de morcelamiento uterino en la Clínica Medellín Antioquia, entre septiembre de 2008 y febrero de 2010. Se realizó muestreo secuencial estricto. Se estimó un tamaño de muestra de 84 pacientes. Se midieron las características sociodemográficas, características del útero, diagnóstico preoperatorio, tiempo quirúrgico, comorbilidades, y complicaciones. Resultados: fueron intervenidos 84 pacientes, de los cuales un 8,33% presentaron complicaciones (n: 7/84), el 3,6% de estas, fueron intraoperatorias (2 lesiones vesicales y 1 lesión rectal) y el 4,76% posoperatorias (1 absceso pélvico con dehiscencia secundaria de la herida, 1 sepsis, 2 granulomas del muñón vaginal). También, fueron encontrados 9 casos de infección del tracto urinario (ITU) (10,71%). Conclusión: La HVSP es una técnica quirúrgica que en manos expertas y con instrumental quirúrgico adecuado, surge como alternativa para el manejo de la patología uterina benigna.
Objective: describing the post-surgical results of vaginal hysterectomy (VH) without uterine prolapse. Materials and methods: this was a cohort study of patients who had undergone vaginal hysterectomy withoutprolapse(VHWP) forbenignuterinepathology using a modified Heaney technique and uterine morcellationtechniquesintheClínicaMedellínbetween September 2008 and February 2010. Strict sequential sampling was done. Patient sample size was estimated at 84. Socio-demographic characteristics, uttering characteristics,pre-operationdiagnosis,timeinsurgery, comorbidities and complications were measured. Results: 84 patients were operated on; complications occurred in 8.33% of them (n: 7/84), 3.6% were intra-operation (2 vesical lesions and 1 rectal lesion) and 4.76% were post-operation (1 pelvic abscess with secondary dehiscence of the wound, 1 sepsis, 2 granulomas of the vaginal cuff). There were 9 cases of urinary tract infection (UTI) (10.71%). Conclusion: VHWP emerges as an alternative for surgical treatment of benign uterine diseases when performed by expert hands and with the appropriate surgical instrumentals.
Assuntos
Humanos , Feminino , Adulto , Histerectomia Vaginal , Complicações Intraoperatórias , Complicações Pós-Operatórias , Prolapso UterinoRESUMO
BACKGROUND: The aim of this study was to evaluate the effect of continuous infusion of ondansetron compared with bolus injection on the incidence of postoperative nausea and vomiting (PONV) in intravenous, patient-controlled analgesia (PCA). METHODS: Sixty three women undergoing laparoscopic-assisted vaginal hysterectomy were randomly allocated according to the method of ondansetron administration: bolus injection of ondansetron (8 mg) after the operation (Bolus group, n = 21); continuous infusion after ondansetron (8 mg) mixed to PCA (PCA 8 mix group, n = 22); and continuous infusion after ondansetron (16 mg) mixed to PCA (PCA 16 mix group, n = 20). The PONV were measured at 1 hr, 6 hr, 24 hr and 48 hr after operation and pain scores (visual analog scale, VAS) were checked. RESULTS: The incidence of PONV during 48 hr in the Bolus group (23.8%) and PCA 16 mix group (20.0%) were significantly lower than PCA 8 mix group (54.5%) (P < 0.05). The three groups showed similar VAS pain scores. CONCLUSIONS: Our results suggest that continuous infusion of ondansetron 16 mg is as effective as a bolus injection of ondansetron (8 mg) at preventing PONV in high-risk patients.