Hysterectomy for benign disease: clinical practice guidelines from the ? French College of Obstetrics and Gynecology
Objective: The objective of the study was to draw up French College of ă Obstetrics and Gynecology (CNGOF) clinical practice guidelines based on ă the best available evidence concerning hysterectomy for benign disease. ă Methods: Each recommendation for practice was allocated a grade, which ă depend...
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Published in | IDEAS Working Paper Series from RePEc |
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Main Authors | , , , , , , , , |
Format | Paper |
Language | English |
Published |
St. Louis
Federal Reserve Bank of St. Louis
01.01.2016
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Abstract | Objective: The objective of the study was to draw up French College of ă Obstetrics and Gynecology (CNGOF) clinical practice guidelines based on ă the best available evidence concerning hysterectomy for benign disease. ă Methods: Each recommendation for practice was allocated a grade, which ă depends on the level of evidence (clinical practice guidelines). ă Results: Hysterectomy should be performed by a high-volume surgeon (>10 ă hysterectomy procedures per year) (grade C). Stimulant laxatives taken ă as a rectal enema are not recommended prior to hysterectomy (grade C). ă It is recommended to carry out vaginal disinfection using ă povidone-iodine solution prior to hysterectomy (grade B). Antibiotic ă prophylaxis is recommended during hysterectomy, regardless of the ă surgical approach (grade B). The vaginal or laparoscopic approach is ă recommended for hysterectomy for benign disease (grade B), even if the ă uterus is large and/or the patient is obese (grade C). The choice ă between these two surgical approaches depends on other parameters, such ă as the surgeon's experience, the mode of anesthesia, and organizational ă constraints (duration of surgery and medical economic factors). Vaginal ă hysterectomy is not contraindicated in nulliparous women (grade C) or in ă women with previous cesarean section (grade C). No specific hemostatic ă technique is recommended with a view to avoiding urinary tract injury ă (grade C). In the absence of ovarian disease and a personal or family ă history of breast/ovarian carcinoma, the ovaries should be preserved in ă premenopausal women (grade B). Subtotal hysterectomy is not recommended ă with a view to reducing the risk of peri-or postoperative complications ă (grade B). ă Conclusion: The application of these recommendations should minimize ă risks associated with hysterectomy. (C) 2016 Elsevier Ireland Ltd. All ă rights reserved. |
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AbstractList | Objective: The objective of the study was to draw up French College of ă Obstetrics and Gynecology (CNGOF) clinical practice guidelines based on ă the best available evidence concerning hysterectomy for benign disease. ă Methods: Each recommendation for practice was allocated a grade, which ă depends on the level of evidence (clinical practice guidelines). ă Results: Hysterectomy should be performed by a high-volume surgeon (>10 ă hysterectomy procedures per year) (grade C). Stimulant laxatives taken ă as a rectal enema are not recommended prior to hysterectomy (grade C). ă It is recommended to carry out vaginal disinfection using ă povidone-iodine solution prior to hysterectomy (grade B). Antibiotic ă prophylaxis is recommended during hysterectomy, regardless of the ă surgical approach (grade B). The vaginal or laparoscopic approach is ă recommended for hysterectomy for benign disease (grade B), even if the ă uterus is large and/or the patient is obese (grade C). The choice ă between these two surgical approaches depends on other parameters, such ă as the surgeon's experience, the mode of anesthesia, and organizational ă constraints (duration of surgery and medical economic factors). Vaginal ă hysterectomy is not contraindicated in nulliparous women (grade C) or in ă women with previous cesarean section (grade C). No specific hemostatic ă technique is recommended with a view to avoiding urinary tract injury ă (grade C). In the absence of ovarian disease and a personal or family ă history of breast/ovarian carcinoma, the ovaries should be preserved in ă premenopausal women (grade B). Subtotal hysterectomy is not recommended ă with a view to reducing the risk of peri-or postoperative complications ă (grade B). ă Conclusion: The application of these recommendations should minimize ă risks associated with hysterectomy. (C) 2016 Elsevier Ireland Ltd. All ă rights reserved. |
Author | Rochambeau, Bertrand Huet, Samantha Lamblin, Gery Gauthier, Tristan Golfier, Francois Gautier Chêne Marcelli, Maxime Deffieux, Xavier Agostini, Aubert |
Author_xml | – sequence: 1 givenname: Xavier surname: Deffieux fullname: Deffieux, Xavier – sequence: 2 givenname: Bertrand surname: Rochambeau fullname: Rochambeau, Bertrand – sequence: 3 fullname: Gautier Chêne – sequence: 4 givenname: Tristan surname: Gauthier fullname: Gauthier, Tristan – sequence: 5 givenname: Samantha surname: Huet fullname: Huet, Samantha – sequence: 6 givenname: Gery surname: Lamblin fullname: Lamblin, Gery – sequence: 7 givenname: Aubert surname: Agostini fullname: Agostini, Aubert – sequence: 8 givenname: Maxime surname: Marcelli fullname: Marcelli, Maxime – sequence: 9 givenname: Francois surname: Golfier fullname: Golfier, Francois |
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Snippet | Objective: The objective of the study was to draw up French College of ă Obstetrics and Gynecology (CNGOF) clinical practice guidelines based on ă the best... |
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SubjectTerms | Clinical medicine Clinical practice guidelines Gynecology Hysterectomy Obstetrics Ovaries Surgeons Vagina |
Title | Hysterectomy for benign disease: clinical practice guidelines from the ? French College of Obstetrics and Gynecology |
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