open access

Vol 93, No 2 (2022)
Research paper
Published online: 2021-05-21
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Impact of clinicopathological variables on laparoscopic hysterectomy complications, a tertiary center experience

Utku Akgör1, Oğuzhan Kuru2, Ali Can Güneş1, Esra Karataş1, B. Esat Temiz1, B. Emre Erzeneoğlu1, Murat Gültekin1, M. Coşkun Salman1, Z. Selçuk Tuncer1, Nejat Özgül1
·
Pubmed: 34105742
·
Ginekol Pol 2022;93(2):105-111.
Affiliations
  1. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
  2. Tepecik Training And Research Hospital, Division of Gynecologic Oncology, Izmir, Turkey

open access

Vol 93, No 2 (2022)
ORIGINAL PAPERS Gynecology
Published online: 2021-05-21

Abstract

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.

Abstract

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.

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Keywords

otal laparoscopic hysterectomy; complication; learning curve; Clavian-Dindo classification

About this article
Title

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

Journal

Ginekologia Polska

Issue

Vol 93, No 2 (2022)

Article type

Research paper

Pages

105-111

Published online

2021-05-21

Page views

6182

Article views/downloads

813

DOI

10.5603/GP.a2021.0097

Pubmed

34105742

Bibliographic record

Ginekol Pol 2022;93(2):105-111.

Keywords

otal laparoscopic hysterectomy
complication
learning curve
Clavian-Dindo classification

Authors

Utku Akgör
Oğuzhan Kuru
Ali Can Güneş
Esra Karataş
B. Esat Temiz
B. Emre Erzeneoğlu
Murat Gültekin
M. Coşkun Salman
Z. Selçuk Tuncer
Nejat Özgül

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