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Geburtshilfe Frauenheilkd 2014; 74(5): 449-453
DOI: 10.1055/s-0034-1368487
Original Article
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

The Decreasing Length of Hospital Stay following Vaginal Hysterectomy: 2011–2012 vs. 1996–1997 vs. 1995–1996

Rückgang der Aufenthaltsdauer nach vaginaler Hysterektomie: 2011–2012 vs. 1996–1997 vs. 1995–1996
P. Reif
Obstetrics & Gynecology, Medical University of Graz, Graz, Austria
,
T. Drobnitsch
Obstetrics & Gynecology, Medical University of Graz, Graz, Austria
,
T. Aigmüller
Obstetrics & Gynecology, Medical University of Graz, Graz, Austria
,
R. Laky
Obstetrics & Gynecology, Medical University of Graz, Graz, Austria
,
D. Ulrich
Obstetrics & Gynecology, Medical University of Graz, Graz, Austria
,
J. Haas
Obstetrics & Gynecology, Medical University of Graz, Graz, Austria
,
A. Bader
Obstetrics & Gynecology, Medical University of Graz, Graz, Austria
,
K. Tamussino
Obstetrics & Gynecology, Medical University of Graz, Graz, Austria
› Author Affiliations
Further Information

Publication History

received 09 April 2014
revised 16 April 2014

accepted 16 April 2014

Publication Date:
06 June 2014 (online)

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Abstract

Background/Definition of the Problem: In recent years, postoperative management has changed towards rapid mobilisation, early oral feeding and rapid rehabilitation (known as Fast-Track or Enhanced Recovery Concepts). This study analysed the postoperative length of stay after vaginal hysterectomy in 3 different periods of time.
Material and Methods: In the period October 2011 – September 2012, 75 patients underwent vaginal hysterectomies (± adnexectomy); another 114 vaginal or laparoscopic hysterectomies with additional operations (e.g. prolapse surgery and incontinence surgery) and malignancies were not included. The time periods August 1995 – July 1996 (n = 50) and October 1996 – September 1997 (n = 96) served as a comparison. Reducing the length of stay was not an explicit goal.
Results: The median postoperative stay was shortened from 7 (5–9) to 5 (3–15) or 3 (0–5) days (p < 0.001). The recovery rate remained unchanged at 2.7 % (n = 2), cf. 2 % (n = 1) and 3.1 % (n = 3). In 40/75 cases (53.3 %), the surgery took place on the day of admission.
Conclusion: The length of hospital stay after vaginal hysterectomy has more than halved since 1995/1996 and continues to decline. This development occurred without a shortened stay being an explicit goal of the clinic. The shortened length of stay does not appear to have a negative impact on postoperative complications and recovery rate.

Zusammenfassung

Hintergrund/Fragestellung: Postoperatives Management hat sich in den letzten Jahren in Richtung rascher Mobilisierung, frühe orale Nahrungsaufnahme und rascher Rehabilitation gewandelt (sog. Fast-Track- oder Enhanced-Recovery-Konzepte). Diese Studie analysiert die postoperative Aufenthaltsdauer nach vaginaler Hysterektomie in 3 Zeiträumen.
Material und Methodik: Im Zeitraum 10/2011–9/2012 wurde bei 75 Patientinnen eine vaginale Hysterektomie (± Adnexektomie) durchgeführt; weitere 114 vaginale oder laparoskopische Hysterektomien mit Zusatzoperationen (z. B. Deszensus-, Inkontinenz-OP) oder Malignomen wurden nicht eingeschlossen. Als Vergleich dienten die Zeiträume 8/1995–7/1996 (n = 50) und 10/1996–9/1997 (n = 96). Reduktion der Aufenthaltsdauer war kein explizites Ziel.
Ergebnisse: Der mediane postoperative Aufenthalt verkürzte sich von 7 (5–9) auf 5 (3–15) bzw. 3 (0–5) Tage (p < 0,001). Die Wiederaufnahmerate blieb unverändert bei 2,7 % (n = 2), vgl. 2 % (n = 1) bzw. 3,1 % (n = 3). In 40/75 Fällen (53,3 %) erfolgte die OP am Aufnahmetag.
Schlussfolgerung: Die Aufenthaltsdauer nach vaginaler Hysterektomie hat sich seit 1995/1996 mehr als halbiert und ist weiterhin rückläufig. Diese Entwicklung passierte, ohne dass ein verkürzter Aufenthalt ein explizites Ziel der Klinik gewesen wäre. Die verkürzte Aufenthaltsdauer zeigt keine negativen Auswirkungen auf die postoperative Komplikations- bzw. Wiederaufnahmerate.

Key words

vaginal - hysterectomy - length of hospital stay - surgery - recovery rate

Schlüsselwörter

vaginal - Hysterektomie - Aufenthaltsdauer - Operation - Wiederaufnahmerate

Supporting Information

 

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