Factors associated with complications and conversion to laparotomy in women undergoing laparoscopically assisted vaginal hysterectomy.

Abstract:

OBJECTIVE:To identify risk factors for complications and conversion to laparotomy in women undergoing laparoscopically assisted vaginal hysterectomy (LAVH). DESIGN:Retrospective study. SETTING:Tertiary referral hospital. POPULATION:All 2012 consecutive women who underwent LAVH for non-malignant diseases in a single institution. METHODS:Retrospective study. MAIN OUTCOME MEASURES:Operative complications and conversion to laparotomy. RESULTS:Most of the LAVHs were successful, but conversion to laparotomy was required in 97 women (4.8%) because of pelvic adhesion (n= 71), large uterine size (n= 18) or bowel injury (n= 8). There were 45 women (2.2%) with complications (bladder injury, 26; bowel injury, 9; vascular injury, 9; and ureteral injury, 1). A history of previous cesarean section (twice or more) was a significant risk factor for complications [odds ratio (OR) 3.38]. A body mass index ≥30 kg/m(2) (OR 2.98), history of previous myomectomy (OR 6.19) and uterine weight ≥500 g (OR 3.24) independently influenced the risk of conversion to laparotomy. CONCLUSIONS:Risk factors identified in this study include a history of previous cesarean section (twice or more) and myomectomy, body mass index ≥30 kg/m(2) and uterine weight ≥500 g. The findings may be useful in counseling women preoperatively about the potential complications of LAVH.

authors

Song T,Kim TJ,Kang H,Lee YY,Choi CH,Lee JW,Kim BG,Bae DS

doi

10.1111/j.1600-0412.2012.01376.x

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

620-4

issue

5

eissn

0001-6349

issn

1600-0412

journal_volume

91

pub_type

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