[Total laparoscopic hysterectomy (TLH): results at a tertiary referral hospital]. / Histerectomía total laparoscópica: resultados en un hospital de tercer nivel de atención.

BACKGROUND: The laparoscopic total hysterectomy is an increasingly applied alternative in the surgical management of uterine pathology. OBJECTIVE: To describe the results obtained in patients that underwent total laparoscopic hysterectomy for the management of benign uterine pathology. MATERIAL AND METHOD: We performed a descriptive, longitudinal and retrospective study in which results on 151 patients who underwent total laparoscopic hysterectomy between October 2008 and July 2011 are reported. RESULTS: The average age of the population was 42.5 years (30-56 years); body mass index averaged 25.8 kg/m2 (18-37 kg/m2). The most common surgical indication was uterine fibroids in 121 cases (80.1%). Among the surgical outcomes, the average operative time was 140.3 minutes (70-275 minutes); average total bleeding, 131 mL (50-400 mL); 3 cases (1.98%) of bladder injury were reported. The immediate postoperative evolution was hospitalization of 1.4 days (1-7 days). Late postoperative complications were fistulas of the urinary tract in 7 cases (4.63%), and in 1 case (0.66%) infection of the vaginal vault. The average weight of surgical specimens was 210 g (50-650 g). CONCLUSIONS: Total laparoscopic hysterectomy is an appropriate therapeutic option We believe that careful selection of patients is critical to providing the best results.

Procedimientos quirúrgicos no ginecológicos, realizados por un servicio de ginecología oncológica / Non gynecological surgical procedures performed at an oncological gynecology service

De marzo de 1987 a julio de 1990, se realizaron 1,568 procedimientos quirúrgicos en el Departamento de Ginecología Oncológica, de los cuales 206 (13.1%) se consideraron procedimientos quirúrgicos "no ginecológicos", 182 (88.3%) fueron secundarios a un diagnóstico de malignidad, siendo el más frecuente el carcinoma de ovario en 54.4%. Dentro de la patología benigna, 11.7% originó cirugía no ginecológica, siendo la más frecuente los procesos pélvicos adherenciales severos en 41.6% y la endometriosis severa en 25%. El procedimiento quirúrgico no ginecológico más frecuente fue linfadenectomía pélvica. Se obtuvo 3.8% de morbilidad y una mortalidad de 0l48% secundaria a un infarto agudo del miocardio. La aceptación del ginecólogo oncólogo es justificada en esta serie en base a supervivencia y morbilidad, permitiendo formar parte de un equipo multidisciplinario.(au)