Association between timing of cervical excision procedure to minimally invasive hysterectomy and surgical complications

<p>Effect of Time Interval Between LEEP and Subsequent Hysterectomy on Postoperative Infectious Morbidity</p>

“…Besides, the population size and distribution of patients does not allow for a balanced evaluation of different time interval levels. 4 To achieve an even distribution in each group, the time interval was divided into three tertiles in our study, and it was analyzed both as continuous and categorical variable. In a brief review of articles of time interval and hysterectomy, our study was the first study till now in which time interval was treated as a continuous variable.…”

“…It was consisted with our subgroup analysis that in the open abdominal group, no statistically significant effect of time interval on infectious morbidity was observed. Other studies focusing on laparoscopic hysterectomies 4 , 16 suggested that time interval between excision and definitive invasive surgery should be greater than 6 weeks to reduce surgical complications. However, the cervical excision procedures were combined with LEEP and CKC, with a dominant proportion of CKC (89/138, 64.49% and 37/55, 67.27%) in both of the two studies.…”

“…However, the cervical excision procedures were combined with LEEP and CKC, with a dominant proportion of CKC (89/138, 64.49% and 37/55, 67.27%) in both of the two studies. 4 , 16 In fact, due to fewer complications and less discomfort, LEEP is now used in preference to CKC for the diagnosis and treatment of cervical intraepithelial neoplasia. In our study, the excision procedure was LEEP alone.…”

“…In addition, except for infectious morbidity, other surgical complications such as ureter and vascular injuries were mixed in the analysis of postoperative complications in previous studies. 4 , 16 However, these injuries might be correlated with type of hysterectomy and surgical skills other than time interval. It is reported that bladder and ureteral injuries were the most common intraoperative complication in radical hysterectomy, and they were associated with para-aortic lymphadenectomy or a larger number of resected lymph nodes.…”

“…It indicated that an open, type I hysterectomy could be conducted at any time. While the result of Sullivan et al 4 showed that time interval between excision and definitive minimally invasive surgery (MIS) should be greater than 6 weeks to reduce surgical complications, however, with cervical incision procedure including both CKC and LEEP. Recently, Yin et al 5 further reported that simple hysterectomy should be performed greater than 4 weeks after conization for CIN III or stage IA1 patients to reduce postoperative infection, with an emphasis on iodoform treatment.…”