INTRODUCTION:The indications for CT scan to evaluate complications of minimally invasive surgery have not been well established. The objective of this study was to identify patient characteristics and clinical findings that correlated with postoperative complications diagnosed on CT scan. METHODS:A retrospective cohort study was conducted with patients who underwent laparoscopic or robotic hysterectomy, from 2011 to 2013, and had a CT scan to evaluate postoperative complications. Patient characteristics and clinical findings were analyzed for association with 1) a CT being ordered 2) abnormal CT findings. RESULTS: 784 patients underwent minimally invasive hysterectomy. 74 (9.4%) had a CT scan. Patients who underwent CT scan were demographically similar to those who did not except for a lower BMI (P5.025) and a trend toward younger age (P5.543). Chronic pain and history of prior abdominal surgery were associated with the CT scan group. There were no significant differences between patients with abnormal versus normal CT scan. In the CT scan group, subgroup analysis of CT findings (primary abnormal, incidental abnormal, normal) demonstrated a significant difference in WBC count (P5.017).CONCLUSION: Patients with smaller BMI, chronic pain, and history of abdominal surgery were more likely to undergo CT scan for workup of postoperative complication, but not more likely to have abnormalities on CT scan. There were no associations between patient characteristics or indications for CT and abnormal CTs. A larger study with more CT scans and abnormal findings may show associations not found in this study. INTRODUCTION:To determine whether preoperative uterine artery embolization (UAE) decreases blood loss during abdominal hysterectomy for fibroid uterus. METHODS: Patients who underwent same day UAE and abdominal hysterectomy at a single institution were identified based on ICD-9 codes. Data collected included blood loss, operating room time, hospital length of stay, and complication rates. This data was then compared with historical data from a study on patients with fibroid uteri .1000 g who just underwent hysterectomy.RESULTS: During 2006-2014, a total of 59 women underwent preoperative UAE prior to hysterectomy for fibroid uterus. Historical data included 47 women as controls. The average uterine size was comparable between cases and controls (153761285 g vs. 16586793.5 g). The estimated blood loss was significantly reduced in the preoperative UAE group when compared to controls, 360.66288.2 mL versus 555.86386.5 mL (P5.004) respectively. Furthermore, women who had preoperative UAE had lower complication rates (21.7%) when compared to controls (61.7%), P,.001. Cases had higher length of stay 3.761.1 days and OR time 217.8656.9 min when compared to controls 2.960.8 days and 124630.6 min (P,.001).CONCLUSION: Preoperative uterine artery embolization decreases blood loss and complication rates for women undergoing abdominal hysterectomy for fibroid uterus.
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