目的:子宫切除术是女性最常见的手术。我们想在2019年对法国的子宫切除术进行评估。我们还评估了子宫切除术的适应症和手术方式随时间的变化,这与可能是修改实践起源的各种事件有关。
方法:我们使用了医学信息系统计划,手术,妇产科和牙科从2009年到2019年提取与子宫切除术有关的所有行为,无论其途径如何。
结果:子宫切除术是一种常见的手术,2019年在法国有近60,000名妇女进行了手术。现在最常用的手术方法是腹腔镜检查,在30%的子宫切除术中进行,其次是剖腹手术(29%),然后阴道方法(26%)和腔阴道(15%)。腹腔镜手术在公立医院比私立医院更常见。附件切除术与41%的子宫切除术有关。在2008年至2019年期间,子宫切除术的数量从2008年的约72,000减少到2019年的约60,000。这种减少发生在新疗法和新建议出现的时期。
结论:子宫切除术数量的演变与传统上进行子宫切除术的病理治疗替代方案的发展相关。
OBJECTIVE: Hysterectomy is the most common procedure in women. We wanted to make an assessment of the hysterectomy in France in 2019. We also assessed the variations over time in the indications and the surgical approch for hysterectomy, this with regard to the various events that may have been at the origin of the modification practices.
METHODS: We used the Medical Information Systems Program in Medicine, Surgery, Obstetrics and Dentistry to extract all acts relating to a hysterectomy regardless of its route of approach from 2009 to 2019.
RESULTS: Hysterectomy is a frequent procedure which was performed in nearly 60,000 women in France in 2019. The most frequently used surgical approach is now laparoscopy, performed in 30% of hysterectomies, followed by laparotomic (29%), then vaginal approaches (26%) and coelio-vaginal (15%). Laparoscopic procedures are performed more often in public than private hospitals. Adnexectomy is associated with 41% of hysterectomies. A decrease in the number of hysterectomies was observed between 2008 and 2019, from approximately 72,000 in 2008 to approximately 60,000 in 2019. This decrease occurs during a period in which new therapies have emerged as well as new recommendations.
CONCLUSIONS: The evolution of the number of hysterectomies is correlated with the development of therapeutic alternatives for pathologies for which a hysterectomy has traditionally been performed.