Clinical Relevance of Conversion Rate and its Evaluation in Laparoscopic Hysterectomy

Twijnstra, Andries R. H.; Blikkendaal, Mathijs D.; Zwet, Erik W. van; Jansen, Frank Willem

doi:10.1016/j.jmig.2012.09.006

Cited by 48 publications

(71 citation statements)

References 66 publications

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“…In our study, the rate of conversion to laparotomy was 9.8%, consistent with recently reported rates for TLH series, which range from 0 to 19% [9]. Some studies on TLH have not found a relationship between BMI and conversion to laparotomy [12,13,14,15,16,17], although several other studies report a higher rate of conversion to laparotomy in obese patients [8,9,10].…”

Section: Discussionsupporting

confidence: 90%

“…Some studies on TLH have not found a relationship between BMI and conversion to laparotomy [12,13,14,15,16,17], although several other studies report a higher rate of conversion to laparotomy in obese patients [8,9,10]. In these studies, morbidly obese patients were either not mentioned or evaluated as a part of the obese group, and not as a distinct group.…”

Section: Discussionmentioning

confidence: 99%

“…However, the reported effects of obesity on the outcomes of TLH are inconsistent. Some studies indicate that obesity increases major complications, the rate of conversion to laparotomy, and the mean operation time [8,9,10,11,12,13,14,15], whereas others report no effects [16,17]. …”

Section: Introductionmentioning

confidence: 99%

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Total Laparoscopic Hysterectomy in Obese and Morbidly Obese Women

Güraslan¹,

Şentürk²,

Doğan³

et al. 2015

Gynecol Obstet Invest

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Background: The study aimed at estimating the effect of body mass index (BMI), used to classify non-obese, obese, and morbidly obese patients, on clinical outcomes in total laparoscopic hysterectomy (TLH) cases. Methods: This retrospective cohort study included 153 patients who underwent TLH for benign, premalignant, or malignant conditions between August 2010 and June 2013. Patients were divided into 3 groups according to BMI, and the following variables were analyzed: operation time, conversion rate, blood loss, total complications, and length of hospital stay. Results: The mean BMI was 33.5 kg/m² (range, 22-61). Forty-four patients were non-obese (BMI <30), 73 were obese (30≤ BMI <40), and 36 were morbidly obese (BMI ≥40). In 138 patients (90.2%), hysterectomy was performed using an endoscopic technique. The rate of conversion to laparotomy (9.8%; 95% confidence interval (CI), 5.1-14.5), blood loss (70.5 ml; range, 10-700), total complications (5.9%), and length of hospital stay (2.9 d; range, 1-8) did not vary according to BMI. Operation time was longer in obese (p = 0.003) and morbidly obese (0.002) patients than in non-obese patients. Conclusion: TLH could be considered a safe and feasible alternative to abdominal hysterectomy in obese and morbidly obese patients.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Total Laparoscopic Hysterectomy in Obese and Morbidly Obese Women

Güraslan¹,

Şentürk²,

Doğan³

et al. 2015

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…There is no obvious explanation as to why a higher age may lead to a higher conversion rate; however, the same result has also been shown for laparoscopic hysterectomy [53] . Also, the higher conversion rate in men is hard to explain.…”

Section: Discussionmentioning

confidence: 74%

Preoperative Risk Factors for Conversion of Laparoscopic Cholecystectomy to Open Surgery - A Systematic Review and Meta-Analysis of Observational Studies

et al. 2016

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Background: Preoperative risk factors for the conversion of laparoscopic cholecystectomy to open surgery have been identified, but never been explored systematically. Our objective was to systematically present the evidence of preoperative risk factors for conversion of laparoscopic cholecystectomy to open surgery. Methods: PubMed and Embase were searched systematically in March 2014. Observational studies evaluating preoperative risk factors for conversion of laparoscopic cholecystectomy to open surgery in patients with gallstone disease were included. The outcome variables extracted were patient demographics, medical history, severity of gallstone disease, and preoperative laboratory values. Results: A total of 1,393 studies were screened for eligibility. We found 32 studies, including 460,995 patients operated with laparoscopic cholecystectomy, eligible for the systematic review. Of these, 10 studies were suitable for 7 meta-analyses on age, gender, body mass index, previous abdominal surgery, severity of disease, white blood cell count, and gallbladder wall thickness. Conclusions: A gallbladder wall thicker than 4-5 mm, a contracted gallbladder, age above 60 or 65, male gender, and acute cholecystitis were risk factors for the conversion of laparoscopic cholecystectomy to open surgery. Furthermore, there was no association between diabetes mellitus or white blood cell count and conversion to open surgery.

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“…Some authors considered that conversion combined the exposure to the general risk of the laparoscopic approach with an additional laparotomy, and is associated with worse postoperative outcomes [20][21][22][23]. To this regard, even if postoperative complications occurred, obviously, more frequently after conversion than laparoscopy, they did not differ between converted and laparotomy groups.…”

Section: Discussionmentioning

confidence: 99%