The Prevalence, Indications, Outcomes of the Most Common Major Gynecological Surgeries in Kazakhstan and Recommendations for Potential Improvements into Public Health and Clinical Practice: Analysis of the National Electronic Healthcare System (2014–2019)

Yesbolat Sakko, Gulzhanat Aimagambetova (), Milan Terzic, Talshyn Ukybassova, Gauri Bapayeva, Arnur Gusmanov, Gulnur Zhakhina, Almira Zhantuyakova and Abduzhappar Gaipov
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Yesbolat Sakko: Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
Gulzhanat Aimagambetova: Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
Milan Terzic: Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
Talshyn Ukybassova: Clinical Academic Department of Women’s Health, CF “University Medical Center”, Astana 010000, Kazakhstan
Gauri Bapayeva: Clinical Academic Department of Women’s Health, CF “University Medical Center”, Astana 010000, Kazakhstan
Arnur Gusmanov: Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
Gulnur Zhakhina: Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
Almira Zhantuyakova: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
Abduzhappar Gaipov: Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan

IJERPH, 2022, vol. 19, issue 22, 1-19

Abstract: Objectives: Major gynecological surgeries are indicated for the treatment of female genital pathologies. It is key to examine trends in gynecologic surgical procedures and updated recommendations by international gynecological societies to find opportunities for improvement of local guidelines. To date, a very limited number of reports have been published on the epidemiology of gynecological surgeries in Kazakhstan. Moreover, some local guidelines for gynecological conditions do not comply with the international recommendations. Thus, this study aims to investigate the prevalence, indications, and outcomes of the most common major gynecological surgeries by analyzing large-scale Kazakhstani healthcare data, and identifying possible opportunities for improvement of the local public health and clinical practice. Methods: A descriptive, population-based study among women who underwent a gynecological surgery in healthcare settings across the Republic of Kazakhstan during the period of 2014–2019 was performed. Data were collected from the Unified Nationwide Electronic Health System (UNEHS). Results: In total, 80,401 surgery cases were identified and analyzed in the UNEHS database for a period of 6 years (2014–2019). The median age of the participants was 40 years old, with 61.1% in reproductive age. The most prevalent intervention was a unilateral salpingectomy—29.4%, with 72.6% patients aged between 18–34 years. The proportion of different types of hysterectomies was 49.4%. In 20% of cases, subtotal abdominal hysterectomy was performed due to uterine leiomyoma. The proportion of laparoscopic procedures in Kazakhstani gynecological practice is as low—11.59%. Conclusions: The Kazakhstani public health and gynecological care sector should reinforce implementation of contemporary treatment methods and up-to-date policies and guidelines. The overall trends in surgical procedures performed for gynecological pathologies, including uterine leiomyoma and ectopic pregnancy treatment, should be changed in favor of the minimally invasive methods in order to adopt a fertility-sparing approach.

Keywords: hysterectomy; salpingectomy; oophorectomy; salpingo-oophorectomy; public health; Kazakhstan; epidemiology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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