When was the last time Sherrell Aston did a tummy tuck? Isn't he around 80? 65 women in 16 years is not a study. I say, repeat the study with a respectable cohort and then talk about the complication rate. That is what TOPS is for. Serena Gordon should do her research before irresponsibly reporting old data without statistical significance, reliability, or validity.
mikieof NJ11:23AM May 18, 2012
Dr Aston's comments are very pertinent. However, the complication rate for abdominal hysterectomy is reported to be from 30 -50% in published reports. Having the abdominoplasty at the same time does not increase the complication rate. Therefore, if suitable, combining these 2 procedures is a very positive experience for our patients despite the complication rate.
Christopher Inglefield9:39AM May 16, 2012
I personally have preformed a good number of these combined hysterectomies and tummy tucks with out any significant complications. I would however not preform this combination on woman with a BMI of 31 or with diabetes. I believe this can be done safely but one must limit the availability to women who are not over weight, don't have diabetes and are generally in good health with out anemia. It seems to me a complication rate of 32% is outrageous and is directly related to patient selection.
Carl W Lentz III MD FACSof FL9:16AM May 16, 2012
In selected patients without medical problems. I agree with Dr. Aston blood transfusion is a major complication; when I performe such combined surgery I make autotrasfusion. It means the patient colect 1week before and we transfund his own blood after the surgery.
Luiz Victor Carneiro7:21PM May 15, 2012
There is no mention in the article of a "control " group.
The study would be more usefull and any conclusions more powerful if the complication rate was compared to that of two other cohorts:
1. a cohort of the patients who had open hysterectomy alone, by the same group of gynecologists, between 1995 and 2011;
2. another cohort of the patients who had abdominoplasty alone, by the same group of surgeons, between 1995 and 2011.
It is unclear from the article, but important to know, whether or not the rates of transfusion, fever, atelectasis, wound complications, urinary tract infection, etc. were compared to and found different from the complication rates of their isolated hysterectomies and isolated abdominoplasties.
Only knowing the results of these comparisons can we consider whether the combining procedures are "safe and effective" or "should be reevaluated".
Moreover, only by comparing the characteristics of the different cohorts (age, BMI, comorbidities, etc.), if their outcomes were different, can we begin to gain new insight into what patient selection, if any, could decrease the complication rates.
John M Pagán6:57PM May 15, 2012
I do agree in combine both procedures, I have been doing this in the last 32 years and the incidence of complications it is not higher if you do it separetly (in my hands) My web page is www.drdavidk.com
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mikie of NJ 11:23AM May 18, 2012
Christopher Inglefield 9:39AM May 16, 2012
Carl W Lentz III MD FACS of FL 9:16AM May 16, 2012
Luiz Victor Carneiro 7:21PM May 15, 2012
John M Pagán 6:57PM May 15, 2012
david kirsch 12:52PM May 15, 2012