A Decline at Inpatient Benign Hysterectomy is Perceived in Brazil: What are the Strategies to Improve Surgical Resident Training?

Abstract

Hysterectomy is one the most performed gynecological surgeries worldwide. 1 A point to be considered for this procedure is the growth of minimally invasive techniques, such as laparoscopy, robotics and vaginal approach for hysterectomy, which have decreased the cost of this procedure. 2 These points have caused a decrease of almost 40% in the number of inpatient hysterectomies in the US. 1 On the other hand, there are several non-surgical options to avoid operating patients with a benign gynecological disease, and they are rising everywhere. n Brazil, few studies have been addressing this point. Accessible data about any surgery is made available by the Brazilian Unified Public Health System (SUS, in the Portuguese acronym) and registered on the database of the Computer Science Department of the SUS (DATASUS, in the Portuguese acronym). We have analyzed the number of admissions for hysterectomies between 2008 and 2017 in the 5 regions of Brazil: a total of 1,004,668 hysterectomies were performed in the period, and the Northeastern Region presented the highest rates (n 394,047/39.22%) compared to the Southeastern (n 326,233), Southern (n 133,383), Midwestern (n 77,751) and Northern (n 74,254) regions.