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Dr. Samimi
Daryoosh Samimi, M.D., F.A.C.O.G.
Researcher - Inventor
Director of US Women Institute
P.O. Box 9870
Fountain Valley, Ca. 92728-9870
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Fax (714) 754-4401 |
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A Randomized Trial of Intrastromal Abdominal Hysterectomy
To Support Shorter Hospital Stays and Prevent Blood Loss
Without Disturbing the Pelvic Support (abstract)
DARY SAMIMI, M.D.,ET. AL.
Fountain Valley Regional Hospital and Medical Center
Fountain Valley, California
OBJECTIVE:
To evaluate the effect of the new Intrastromal abdominal hysterectomy as a bloodless nerve-sparing
method without disturbing the pelvic support system, versus the conventional abdominal hysterectomy.
Additionally, to evaluate this method as an alternative procedure to prevent blood loss and enable
a shorter hospital stay with fewer complications.
METHODS:
The hysterectomy can be performed using the following techniques — conventional, abdominal, vaginal,
or laparoscopic assisted vaginal hysterectomy, intrafascial, extrafascial, and lastly the supracervical
hysterectomy. The supracervical hysterectomy has been criticized in medical literature due to the
number of patients developing cancer in the cervical stump that may lead to fatality. Moreover, it is
important to acknowledge that the supercervical hysterectomy is expensive, which is to be attributed to
the cost incurred as a result of the preventive measures considered for cancer.
The new intrastromal T.A.H. keeps the cardinal, utereosacral ligament, and vaginal apex unsevered.
In the meantime, the entire cervix’s endocervical canal and the T-zone with uterus are removed,
whereas the bed and the pericervical stroma remain. In the outer stroma of the cervix is a
pericervical bed, and the cervix is removed from this bed.
A total of forty women were placed in this prospectively randomized clinical trial of the
Intrastromal Abdominal Hysterectomy. Patients were randomized into two groups. In the study
group (n=20), Intrastromal Abdominal Hysterectomy was performed from May 2000 — Sept 2001.
In the control group (n=20), a conventional hysterectomy was performed, before April 2000.
RESULTS:
There were differences in the average blood loss
(
hemoglobin 1.0 versus
1.4 g/dl, P0.00l ), and the average hospital stay (2.7 days versus 3.15 days, P=0.005)
was in favor of the study group. There were no post-operation infections, ureter injuries,
vaginal vault prolapses, and no post-hysterectomy fistula were seen.
CONCLUSION:
Intrastromal Abdominal Hysterectomy is a bloodless, nerve-sparing technique that does not disturb
the pelvic support system. It also proves to be an effective alternative to the traditional
hysterectomy, with advantages such as reduced blood loss, shorter hospital stay, and less frequent
post-operation complications. Throughout this process, it is imperative that the patient’s fear
cervical cancer should not be ignored.
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