Minimally invasive hysterectomy rates in Quebec: trends over the last decade and predictors of technicity
CANSAGE ePoster Library. SIMON V. 09/27/19; 279821; eP-139
Vanille SIMON
Vanille SIMON
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Abstract
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Objective: To assess trends and predictors of the technicity index for hysterectomies in Quebec.
Methods: We used the ADAM (Analyse en direct des actes médicaux) database to determine the number and surgical approach of hysterectomies annually performed within 81 hospitals of the province of Quebec from 2007 to 2017. We calculated the technicity index (number of hysterectomies performed vaginally and laparoscopically over the total number of hysterectomies) for each hospital and trends in surgical approach (Cochran-Artimage test). We used logistic regression to assess potential predictors (university center, urban area, volume of hysterectomies, number of gynecologists per hospital) of a high technicity index (>70%). Hysterectomies performed for an oncologic condition were excluded as well as hospitals where less than 30 hysterectomies were performed annually.
Results: A total of 59 hospital centers were eligible. Over the last decade (2007-2017), technicity increased from 43% to 66% (p70% were located in rural areas (< 100,000 inhabitants).
Conclusion: The proportion of hysterectomies performed with a minimally invasive approach continues to increase. Teaching offered in university centers as well as mentoring given by advanced laparoscopists likely contributed to the improvement of the technicity index throughout the province.
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