Acta obstetricia et gynecologica Scandinavica · 2012
Factors associated with complications and conversion to laparotomy in women undergoing laparoscopically assisted vaginal hysterectomy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Song Taejong, Kim Tae-Joong, Kang Heeseok, Lee Yoo-Young, Choi Chel Hun, Lee Jeong-Won, Kim Byoung-Gie, Bae Duk-Soo
Аннотация
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.
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.