Trends in Mode of Gynecologic Surgery for Benign Disease in Brazil
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Citações na Scopus
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Tipo de produção
article
Data de publicação
2021
Título da Revista
ISSN da Revista
Título do Volume
Editora
MARY ANN LIEBERT, INC
Autores
ROA, Lina
RAMOS, Jania Arcia
CITRON, Isabelle
STAFFA, Steven J.
ZURAKOWSKI, David
BOATIN, Adeline A.
Citação
JOURNAL OF GYNECOLOGIC SURGERY, v.37, n.4, p.337-344, 2021
Resumo
Objective: There are limited studies on laparoscopy for benign hysterectomy in low- and middle-income countries. This article describes national trends in modes of hysterectomy in Brazil and compares outcomes by regions and health sectors. Materials and Methods: This was a cross sectional retrospective analysis of benign hysterectomies from open-access national databases (public sector: 2008-2017; private sector: 2016) in Brazil. Variables examined included the modes (vaginal, abdominal, and laparoscopic) of hysterectomies, geographic regions, mortality rates, and lengths of stay (LOS). Results: Benign hysterectomies decreased by 19.2% over 10 years. The proportion of abdominal surgeries increased from 85% to 88%. Despite an increase in laparoscopic surgeries (0.2-0.9%), minimally invasive surgery (vaginal and laparoscopic) decreased (14.7%-12.6%), largely driven by a drop in vaginal cases (14.5%-11.7%). More laparoscopic hysterectomies were performed in the private sector compared to the public sector (11% versus 1%; p < 0.001). There were significant geographic disparities, with 17% of hysterectomies in the private sector performed laparoscopically in the south compared to 9% in the northeast (p < 0.001). Conclusions: Trends in modes of hysterectomies have changed. There are regional inequities, with wealthier regions accessing more laparoscopic surgery. Understanding the trends and factors affecting access to laparoscopy is essential for ensuring equitable access to high-quality gynecologic care.
Palavras-chave
global surgery, laparoscopic surgery, benign hysterectomy, equity
Referências
- ALONSO NIVALDO, 2017, Rev. Col. Bras. Cir., V44, P202, DOI 10.1590/0100-69912017002016
- Bittencourt Sonia Azevedo, 2006, Cad. Saúde Pública, V22, P19, DOI 10.1590/S0102-311X2006000100003
- Chao TE, 2016, SURG ENDOSC, V30, P1, DOI 10.1007/s00464-015-4201-2
- Choy I, 2013, SURG ENDOSC, V27, P4009, DOI 10.1007/s00464-013-3019-z
- Cohen SL, 2014, JSLS-J SOC LAPAROEND, V18, DOI 10.4293/JSLS.2014.00096
- Dedden SJ, 2017, EUR J OBSTET GYN R B, V216, P212, DOI 10.1016/j.ejogrb.2017.07.015
- Doniec K, 2018, LANCET, V392, P731, DOI 10.1016/S0140-6736(18)30853-5
- Garry R, 2004, BRIT MED J, V328, P129, DOI 10.1136/bmj.37984.623889.F6
- Huang CC, 2020, J MINIM INVAS GYN, V27, P65, DOI 10.1016/j.jmig.2019.02.020
- Jacoby VL, 2009, OBSTET GYNECOL, V113, P1259, DOI 10.1097/AOG.0b013e3181a66c42
- Lefebvre G, 2018, J OBSTET GYNAECOL CA, V40, P567, DOI 10.1016/j.jogc.2018.04.031
- Lykke R, 2013, EUR J OBSTET GYN R B, V171, P333, DOI 10.1016/j.ejogrb.2013.09.011
- Massenburg BB, 2017, BMJ GLOB HEALTH, V2, DOI 10.1136/bmjgh-2016-000226
- Matteson KA, 2017, OBSTET GYNECOL, V129, pE155, DOI 10.1097/AOG.0000000000002112
- Nacul MP, 2015, ABCD-ARQ BRAS CIR DI, V28, P81, DOI [10.1590/S0102-67202015000100020, 10.1590/s0102-67202015000100020]
- Nieboer TE, 2009, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD003677.pub4
- Olijnyk JG, 2014, WORLD J SURG, V38, P1912, DOI 10.1007/s00268-014-2493-3
- Price JT, 2017, AM J OBSTET GYNECOL, V217, DOI 10.1016/j.ajog.2017.07.036
- Rooney CM, 2005, AM J OBSTET GYNECOL, V193, P2041, DOI 10.1016/j.ajog.2005.07.090
- Scheffer M, 2017, CAD SAUDE PUBLICA, V33, DOI [10.1590/0102-311x00104717, 10.1590/0102-311X00104717]
- Spilsbury K, 2006, BJOG-INT J OBSTET GY, V113, P804, DOI 10.1111/j.1471-0528.2006.00962.x
- Wells KM, 2016, SURGERY, V160, P509, DOI 10.1016/j.surg.2016.04.001
- Wells Katie M, 2015, Lancet, V385 Suppl 2, pS38, DOI 10.1016/S0140-6736(15)60833-9
- Whiteman MK, 2008, AM J OBSTET GYNECOL, V198, DOI 10.1016/j.ajog.2007.05.039