Impact of clinicopathological variables on laparoscopic hysterectomy complications, a tertiary center experience.

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Akgör U., Kuru O., Güneş A. C., Karataş E., Temiz B. E., Erzeneoğlu B. E., ...Daha Fazla

Ginekologia polska, cilt.93, ss.105-111, 2022 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 93
  • Basım Tarihi: 2022
  • Doi Numarası: 10.5603/gp.a2021.0097
  • Dergi Adı: Ginekologia polska
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, Gender Studies Database, MEDLINE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.105-111
  • Anahtar Kelimeler: total laparoscopic hysterectomy, complication, learning curve, Clavian-Dindo classification, URINARY-TRACT INJURY, SURGICAL COMPLICATIONS, RADICAL HYSTERECTOMY, UTERINE WEIGHT, OUTCOMES, RISK, CLASSIFICATION, SURGERY, OBESITY, CANCER
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

Objectives: To analyze intraoperative and postoperative complications according to Clavian-Dindo Classification (CDC) and evaluate the influence of clinicopathological features on the feasibility and safety of total laparoscopic hysterectomy (TLH) in patients that underwent surgery in a tertiary center. Material and methods: We retrospectively reviewed the database of 469 patients that underwent surgery for patients who underwent extra facial TLH from 2013 to 2020. Results: A total of 86 (18.3%) peri-postoperative complications were observed. The incidence of intraoperative complications was 2% (n = 10). The overall conversion rate to open surgery was 1.9% (n = 9). A total of 76 postoperative complications were observed in 61 patients (14.3%). The incidence of minor [Grade I (n = 16, 3.4%) and II (n = 42, 8.9%)] and major complications [Grade III (n = 15, 3.2%), IV (n = 2, 0.4%) and V (n = 1, 0.2%)] were 12.3% and 3.8%, respectively. A higher BMI and performing surgery at the first step of learning are found to be associated with intraoperative and postoperative complications (p < 0.05). Postoperative complications related to having a history of the cesarean section, additional comorbidities, and uterine weight >= 300 g (p < 0.05). Conclusions: The implementation of TLH by experienced surgeons appears to have remarkable advantages over open surgery. However, the risk factor for complications should be taken into account by surgeons in the learning curve in selecting the appropriate patient for surgery.