Predictors of 30‐day morbidity after hysterectomy for benign disease

Shim, Seung‐Hyuk; Suh, Junghwa; Park, Ji‐Eun; Lee, Sun-Joo; Lee, Ji-Young; Kim, Soo-Nyung; Kang, Soon‐Beom

doi:10.1002/ijgo.12752

Cited by 10 publications

(4 citation statements)

References 30 publications

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“…Mereu et al reported a mean age of 49.6 ± 6.5 years among patients who underwent TLH due to benign diseases [10]. Shim et al also reported a mean age of 48 years [11].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Total Laparoscopic Hysterectomy: A Single-Surgeon Experience of Initial 50 Cases

Ashfaq¹,

Samina²,

Jabeen³

et al. 2021

Cureus

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In this study, we reported a single surgeon experience of total laparoscopic hysterectomy (TLH) in terms of intraoperative and early postoperative outcomes and complications. In addition, we compared our results with published literature for a reevaluation of complications and outcomes. Material and methodsThis present prospective study was conducted on 50 patients who underwent TLH due to benign causes. Patients diagnosed with abnormal uterine bleeding (AUB), uterine fibroids, and post-menopausal bleeding (PMB) were included in this analysis. Patients were discharged after 24 hours of surgery if there were considered fit for discharge. The patients' age, co-morbidities, size of the uterus, additional procedure along with TLH, and postoperative complications were collected and analyzed. The follow-up period was three months, done on the tenth day after surgery, the thirtieth day, and then at three months. ResultsThe mean age of our patients was 46.42±5.01 years. The major indication of hysterectomy was fibroids diagnosed in 27 (54.0%) patients and AUB in 18 (36.0%) patients. Out of 50, 10 (20.0%) patients had a previous cesarean section, and 4 (8.0%) had a bilateral tubal ligation (BTL). Mean surgery duration was 124.26±44.74 minutes. Mean hospital stay was 2.18±0.39 days. Total complications occurred in five (10.0%) patients, ureteric injury in one (2.0%) patient, port-site infections in 2 (4.0%), and vault infections in 2 (4.0%) patients. ConclusionTLH is a safe procedure and can be performed with minimal complications in patients with benign uterine etiology.

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“…Mereu et al reported a mean age of 49.6 ± 6.5 years among patients who underwent TLH due to benign diseases [10]. Shim et al also reported a mean age of 48 years [11].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Total Laparoscopic Hysterectomy: A Single-Surgeon Experience of Initial 50 Cases

Ashfaq¹,

Samina²,

Jabeen³

et al. 2021

Cureus

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“…Determination of pre-operative comorbid medical conditions, ensuring pre-operative optimization of them and the appropriate selection of surgical approaches are important; however, this may not always be possible in emergency surgeries. In the 5-year retrospective study of Shim et al,[ 26 ] the 30-day morbidity rate was determined to be 4.5% (n=72) in patients (n=1609) undergoing hysterectomy for benign indications. Urinary complications wound infection, blood transfusion more than 4 units, and Charlson comorbidity index of 2 or more, OT were determined to be independent risk factors for morbidity.…”

Section: Discussionmentioning

confidence: 99%

Use of a Modified Surgical APGAR Score for Prediction of Postoperative Complications in Emergency Surgery: an observational retrospective study

Yakar¹

2021

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The surgical Apgar score (SAS) was defined by Gawande et al. in 2007. It has been shown that this scoring system was highly effective for predicting the incidence of post-operative complications and mortality. In this study, we aimed to define a new, modified SAS (mSAS) for predicting the incidence of post-operative complications and mortality in emergency surgery. We also wanted to quantify the effectiveness of this modified scoring system, comprising of the duration of the operation in addition to the three intraoperative parameters of the SAS score. METHODS: Five hundred and seventy-nine patients who underwent emergency surgery were enrolled in this retrospective observational study. At the end of the operation, the SAS was calculated from the data obtained from the examination of the patients and the mSAS was calculated by adding the duration of the operation to data used in the calculation of the SAS (Surgical duration >8 h; –4 points; 7.01–8 h; –3 points; 5.01–7 h; –2 points; 3.01–5 h; –1 points; 0–3 h; 0 points added). RESULTS: There was a statistically significant relationship between the mSAS and the total number of complications (as operative time [OT] increased, the number of complications increased) (r=0.360; p=0.001). The compliance levels of the SAS and mSAS were 98.4% and they have been found as statistically significant (ICC: 0.984; p=0.001; p<0.01). CONCLUSION: We suggest that the OT should be included as a simple, objective and practical indication of the SAS risk score in major operations. The mSAS was an independent predictor of post-operative mortality and complications. With the widespread use of electronic medical record systems and the effective use of pre-operative medical data, the mSAS can be used as an easy and new scoring system to predict prognosis.

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“…The primary endpoint was 30‐day postoperative morbidity according to the National Surgical Quality Improvement Program 21 . The postoperative variables for comparing surgical outcomes between the two groups were as follows 22–25 : time to surgery; estimated blood loss (EBL); hemoglobin change; time to resume a normal diet; length of postoperative hospital stay; conversion to laparotomy; and 30‐day readmission after hysterectomy. The operative time was defined as the time from skin incision to skin closure.…”

Section: Methodsmentioning

confidence: 99%

Impact of resident participation on surgical outcomes in laparoscopically assisted vaginal hysterectomy

Lee,

Kim,

Jang

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo compare surgical outcomes in patients with benign diseases who underwent laparoscopically assisted vaginal hysterectomy (LAVH) to determine the association between surgical outcomes and resident participation in the gynecologic field.MethodsA single‐center retrospective study was conducted of patients diagnosed with benign gynecologic diseases who underwent LAVH between January 2010 and December 2015. Clinicopathologic characteristics and surgical outcomes were compared between the resident involvement and non‐involvement groups. The primary endpoint was the 30‐day postoperative morbidity. Observers were propensity matched for 17 covariates for resident involvement or non‐involvement.ResultsOf the 683 patients involved in the study, 165 underwent LAVH with resident involvement and 518 underwent surgery without resident involvement. After propensity score matching (157 observations), 30‐day postoperative morbidity occurred in 6 (3.8%) and 4 (2.5%) patients in the resident involvement and non‐involvement groups, respectively (P = 0.501). The length of hospital stay differed significantly between the two groups: 5 days in the resident involvement group and 4 days in the non‐involvement group (P < 0.001). On multivariate analysis, Charlson Comorbidity Index >2 (odds ratio [OR] 8.01, 95% confidence interval [CI] 2.68–23.96; P < 0.001), operative time (OR 1.02, 95% CI 1.01–1.03; P < 0.001), and estimated blood loss (OR 1.00, 95% CI 1.00–1.00; P < 0.001) were significantly associated with 30‐day morbidity, but resident involvement was not statistically significant.ConclusionThere was no significant difference in the 30‐day morbidity rate when residents participated in LAVH. These findings suggest that resident participation in LAVH may be a viable approach to ensure both residency education and patient safety.

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Predictors of 30‐day morbidity after hysterectomy for benign disease

Cited by 10 publications

References 30 publications

Outcomes of Total Laparoscopic Hysterectomy: A Single-Surgeon Experience of Initial 50 Cases

Outcomes of Total Laparoscopic Hysterectomy: A Single-Surgeon Experience of Initial 50 Cases

Use of a Modified Surgical APGAR Score for Prediction of Postoperative Complications in Emergency Surgery: an observational retrospective study

Impact of resident participation on surgical outcomes in laparoscopically assisted vaginal hysterectomy

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