Comparativo entre as principais vias de realização de histerectomias e seus desfechos clínicos e epidemiológicos

Abstract

To compare the techniques of the three main ways of performing hysterectomies and their clinical and epidemiological outcomes. Method: cross-sectional, quantitative study with analysis of data filled in hospital-based clinical records, based on the analysis of 94 medical records, carried out between April and December 2021 at the Gynecology Hospital de Clinicas (HC) sector, in Passo Fundo. All patients who underwent hysterectomy for benign causes between January 1, 2010 and December 31, 2020 were included. Analyzed variables: age, skin color, education, origin, underlying disease, type of procedure performed, length of stay , postoperative hemorrhage, presence of intraoperative or postoperative complications, uterine volume and parity. Results: of the 482 medical records analyzed, 94 were included in the study. There was a pattern of white women (98%), aged between 45 and 60 years and with more than 12 years of schooling (51.0%). Regarding the classification of the underlying disease, the uterine body polyps (28.7%) were responsible for most of the indications for hysterectomies. The most common surgical approach was via the vaginal route, representing (64.9%) of the procedures. As for the length of stay, it was 1 to 2 days for (86.2%) of the patients and hospital discharge took place within 24 hours after the surgical procedure. With regard to uterine volume, (10.6%) represented a uterine volume greater than one hundred and in relation to parity, (43.6%) of the patients were multiparous. As for postoperative complications, (84.0%) did not present any complications, with the absence of hemorrhages represented in (86.2%). Conclusion: When comparing the three main routes of hysterectomies, the vaginal route has been the main route of choice, contributing to fewer intra and postoperative complications and to a better clinical outcome, shorter hospital stay, less chance of bleeding, and a faster return to daily activities. Regarding the demographic profile, the profile of women undergoing hysterectomy are middle-aged, white, educated and multiparous.