Effect of Extreme Obesity on Outcomes in Laparoscopic Hysterectomy

Siedhoff, Matthew T.; Carey, Erin T.; Findley, Austin D.; Riggins, L.E.; Garrett, Joanne M.; Steege, John F.

doi:10.1016/j.jmig.2012.07.005

Cited by 67 publications

(39 citation statements)

References 31 publications

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“…Most studies on TLH and obesity reported no association between BMI and operative complications for TLH [8,14,16]. However, a more recent study reported that the major complication frequency was associated with BMI, even though the total number of complications was the same [11]. According to Siedhoff et al, for every 10-unit increase in BMI, the complication rate increases 1.5 fold [11].…”

Section: Discussionmentioning

confidence: 99%

“…However, a more recent study reported that the major complication frequency was associated with BMI, even though the total number of complications was the same [11]. According to Siedhoff et al, for every 10-unit increase in BMI, the complication rate increases 1.5 fold [11]. Morgan-Ortiz et al reported similar results in 2013 [12].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the operation time, the non-surgical operating room time is also prolonged in obese patients [11]. However, a few studies report no effect of obesity on operation time [16,17].…”

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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

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“…This classification system can account for very serious adverse events (e.g., anaphylaxis, malignant hyperthermia, and intraoperative cardiac arrest) that might not result in a permanent adverse outcome but nonetheless should be captured. The ClavienDindo Classification System has been successfully applied in gastrointestinal surgery, 89,90 gynecology, 91,92 orthopedics, 93 and urology.…”

Section: Special Articlesmentioning

confidence: 99%

An Analysis of Methodologies That Can Be Used to Validate if a Perioperative Surgical Home Improves the Patient-centeredness, Evidence-based Practice, Quality, Safety, and Value of Patient Care

et al. 2013

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Approximately 80 million inpatient and outpatient surgeries are performed annually in the United States. Widely variable and fragmented perioperative care exposes these surgical patients to lapses in expected standard of care, increases the chance for operational mistakes and accidents, results in unnecessary and potentially detrimental care, needlessly drives up costs, and adversely affects the patient healthcare experience. The American Society of Anesthesiologists and other stakeholders have proposed a more comprehensive model of perioperative care, the Perioperative Surgical Home (PSH), to improve current care of surgical patients and to meet the future demands of increased volume, quality standards, and patient-centered care. To justify implementation of this new healthcare delivery model to surgical colleagues, administrators, and patients and maintain the integrity of evidenced-based practice, the nascent PSH model must be rigorously evaluated. This special article proposes comparative effectiveness research aims or objectives and an optimal study design for the novel PSH model.

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