{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:03:01Z","timestamp":1790013781652,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Minimally Invasive Surgery"],"published-print":{"date-parts":[[2022,9,15]]},"abstract":"<jats:p>Introduction. Hysterectomy is the most common gynaecological operation worldwide. The objective of the study is to analyze the various routes of hysterectomy and its complications when the decision of route is based on using a prospective algorithm tree. Methodology. It is an observational study to analyze the route of hysterectomy based on using a prospective algorithm. The decision tree is based on pelvic pathology, uterine size, vaginal access, pelvic adhesion, competency of the surgeon, choice of the patient, and complication of different routes of hysterectomy. Data were collected from preoperative, intraoperative, and postoperative records. Demographic factors, indications, routes of hysterectomy, and complications were recorded and analyzed by using SPSS software version 22. Observation. Among the malignant or suspected malignant pathology groups, TAH was performed in 89 cases and TLH was performed in 3 cases. Among the benign disease groups, VH was performed in 137(38.2%) cases, TAH was performed in 118(32.9%) cases, and TLH was performed in 104 (28.9%) cases. Operative time and a number of blood transfusions were significantly less with VH (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                     <\/a:math>\n                  <\/jats:inline-formula> value\u2009&lt;\u20090.0001 and 0.004) compared to abdominal and total laparoscopic hysterectomy. Postoperative complication such as fever was more with abdominal hysterectomy (&lt;i&gt;<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                     <\/c:math>\n                  <\/jats:inline-formula>-&lt;\/i&gt;value&lt;0.00001) compared to VH and TLH. Vaginal discharge was more with VH and TLH compared to TAH (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                     <\/e:math>\n                  <\/jats:inline-formula> value \u22120.004) and wound infection was more in the abdominal route (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                     <\/g:math>\n                  <\/jats:inline-formula> value 0.001). Conclusion. The abdominal route was the route of choice for surgery in malignancy or suspected malignant pathology. In benign pathology, VH was the most common and preferable route of surgery. Complications were found to be minimal with vaginal hysterectomy.<\/jats:p>","DOI":"10.1155\/2022\/6034113","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T21:35:09Z","timestamp":1663277709000},"page":"1-7","source":"Crossref","is-referenced-by-count":9,"title":["Analysis of Different Routes of Hysterectomy Based on a Prospective Algorithm and Their Complications in a Tertiary Care Institute"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7630-501X","authenticated-orcid":true,"given":"Subrat","family":"Panda","sequence":"first","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3323-6661","authenticated-orcid":true,"given":"Ananya","family":"Das","sequence":"additional","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rituparna","family":"Das","sequence":"additional","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nalini","family":"Sharma","sequence":"additional","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wansalan","family":"Shullai","sequence":"additional","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinayak","family":"Jante","sequence":"additional","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusuya","family":"Sharma","sequence":"additional","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaushiki","family":"Singh","sequence":"additional","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prateeti","family":"Baruah","sequence":"additional","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruksana","family":"Makakmayum","sequence":"additional","affiliation":[{"name":"NEIGRIHMS, Shillong, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.05.039"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1097\/grf.0000000000000009"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(82)90362-3"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(94)00318-8"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(95)91158-8"},{"key":"6","first-page":"89","article-title":"The impact of laparoscopicsurgery on vaginal hysterectomy","volume":"2","author":"D. Querleu","year":"1993","journal-title":"Gynecol Endosc"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2007.06.004"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.01.003"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/s0020-7292(00)00316-7"},{"issue":"1","key":"10","first-page":"CR24","article-title":"Hysterectomy surveillance in the United States-1997 through 2005","volume":"14","author":"R. M. Merrill","year":"2008","journal-title":"Medical Science Monitor"},{"key":"11","volume-title":"National Hospital DischargeSurvey: 2006 Summary","author":"V. C. Buie","year":"2010"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1097\/01.aog.0000285997.38553.4b"},{"key":"13","doi-asserted-by":"crossref","first-page":"689","DOI":"10.18203\/2320-1770.ijrcog20183778","article-title":"An audit of hysterectomies: indications, complications, clinic pathological analysis of hysterectomy specimens in a tertiarycare center","volume":"7","author":"V. Sivapragasam","year":"2018","journal-title":"International Journal of Reproduction, Contraception, Obstetrics and Gynecology"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.18203\/2320-1770.ijrcog20183782"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003677.pub5"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.12701\/yujm.2020.00185"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7506.1478"},{"key":"18","article-title":"Ten years of progress\u2014improvedhysterectomy outcomes in Finland 1996\u20132006: a longitudinal observational study","volume":"3","author":"T. B. M\u00e4kinen","year":"2013","journal-title":"Juha"},{"issue":"3","key":"19","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD003677.pub4","article-title":"Surgicalapproach to hysterectomy for benign gynecological disease","author":"T. E. Nieboer","year":"2009","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"20","doi-asserted-by":"crossref","DOI":"10.1186\/s10397-020-01068-1","article-title":"Fouad Chaalan & Abdelbaset Fakhry Laparoscopichysterectomy versus total abdominal hysterectomy: a retrospective study at a tertiaryhospital","volume":"17","author":"M. E. Aboulfotouh","year":"2020","journal-title":"Gynecological Surgery"},{"issue":"8","key":"21","first-page":"38","article-title":"MeritsAnd demerits of different routes of hysterectomy for gynecological ConditionsWithout uterine","volume":"16","author":"Y. Radhika Ganesh","year":"2017","journal-title":"DescentJournal of Dental and Medical Sciences"},{"key":"22","article-title":"Vaginal vault closure techniques in totallaparoscopic hysterectomy: a comparison between laparoscopic route vault suturingand vaginal route suturing","volume":"2","author":"K. Singh","year":"2011","journal-title":"National Journal of Community Medicine"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1806395"},{"issue":"1","key":"24","first-page":"95","article-title":"Hysterectomy: a historical perspective","volume":"11","author":"C. Sutton","year":"1997","journal-title":"Bailli\u00e8re\u2019s Clinical Obstetrics and Gynaecology"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1016\/j.gmit.2013.02.004"},{"issue":"3","key":"26","first-page":"358","article-title":"Does route ofHysterectomy affect outcome in obese and nonobese women?","volume":"13","author":"P. R. Brezina","year":"2009","journal-title":"Journal of the Society of Laparoendoscopic Surgeons"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2021.1958111"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2020.1741523"}],"container-title":["Minimally Invasive Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/mis\/2022\/6034113.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/mis\/2022\/6034113.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/mis\/2022\/6034113.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T21:35:24Z","timestamp":1663277724000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/mis\/2022\/6034113\/"}},"subtitle":[],"editor":[{"given":"Imtiaz","family":"Wani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,9,15]]},"references-count":28,"alternative-id":["6034113","6034113"],"URL":"https:\/\/doi.org\/10.1155\/2022\/6034113","relation":{},"ISSN":["2090-1453","2090-1445"],"issn-type":[{"value":"2090-1453","type":"electronic"},{"value":"2090-1445","type":"print"}],"subject":[],"published":{"date-parts":[[2022,9,15]]}}}