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Indian Journal of Maternal-Fetal & Neonatal Medicine 2(1):p 27-30, Jan-Jun 2015. | DOI: DOI: https://dx.doi.org/10.21088/ijmfnm.2347.999X.2115.6
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Gynaecological Surgery in Rural set up- Intraoperative and Postoperative Complications
Sambarey Pradip W.* , Sambarey Pradip W.* , Patil Sunil S.** , Dayama Shridhar S.***
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Indian Journal of Maternal-Fetal & Neonatal Medicine 2(1):p 27-30, Jan-Jun 2015. | DOI: DOI: https://dx.doi.org/10.21088/ijmfnm.2347.999X.2115.6
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Abstract
Gynaecological surgeries are increasing in spite of growing trend towards endoscopic surgeries. Both abdominal and vaginal hysterectomies are being done for various indications, more so in rural based hospitals. In our rural based medical college hospital more than 400 hysterectomies were done in last 2 years for various indications.This study analysis various intra and postoperative complications in those surgeries, mostly hysterectomies, predisposing factors and causes for them and how we managed them. In a period of 2 years [ Oct.2012 to Sept.2014], 200 abdominal and 225 vaginal hysterectomies done in this hospital for menstrual abnormalities including DUB, fibroids, Uterovaginal prolapse and adenomyosis. Intra-operative bleeding [65], bladder injury [06], bowel injury[02],paralytic ileus[17], wound sepsis[35], burst abdomen[01], DVT[02], postoperative retention of urine[12] etc. were common complications. Pre-existing anaemia, diabetes , hypertension, cardiac disease, previous surgeries, urinary tract infections, obesity, lung infections etc. were some of the predisposing factors for those morbidities while more vascularity, fibrosis, operating in wrong plane, bowel and bladder adhesions, obesity, compromised instrument quality, inadequate relaxation, overcrowding in OT, inadequate light in OT, frequent shut downs while operating, longer duration for surgery etc. were common causes for the complications during surgery. Although there was no mortality in this study, requirement of blood transfusions, higher antibiotics, frequent dressings, resuturing, increased hospital stay, frequent catheterisation etc do require some thinking and consideration. Proper selection of case, timing of surgery, improving surgical skill, hospital infrastructure, and operation theatre facilities can be of some help in decreasing those complications and improving results.
Keywords: Abdominal Hysterectomy; Vaginal Hysterectomy; Intra and Post Operative Complications.
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DOI: DOI: https://dx.doi.org/10.21088/ijmfnm.2347.999X.2115.6
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