Impact of Diabetes Mellitus on Postoperative Complications Following Laparoscopic Hysterectomy for Benign Indications

Corrigan, K; Vargas, Maria V.; Robinson, H.N.; Gu, Alex; Wei, Chapman; Tyan, Paul; Singh, Neha; Tappy, Erryn; Moawad, Gaby

doi:10.1159/000501034

Cited by 14 publications

(14 citation statements)

References 16 publications

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“…Therefore, it is necessary to measure and control FBS levels in those undergoing surgery. These results are in line with the findings of Corrigan et al (22), Jiamset et al (23), and Fakhari et al (11).…”

Section: Laboratory Testssupporting

confidence: 93%

Assessment of the Relationship of Anthropometric Indices With Vitamin D, Zinc, and Fasting Blood Sugar Levels in Women With and Without Infection Following Abdominal Hysterectomy: A Case-Control Study

Mousavi

Osquee

Haghdoost

2020

International Journal of Women’s Health and Reproduction Scienc

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Objectives: It is necessary to prevent postoperative infection following abdominal hysterectomy. The present study aimed to assess the relationship of anthropometric indices with vitamin D, zinc (Zn), and fasting blood sugar (FBS) levels in women with and without infection following abdominal hysterectomy in order to determine the exact effects of these factors on infection. Materials and Methods: This case-control study was conducted in three teaching hospitals affiliated with Tabriz University of Medical Sciences in an 18-month period leading up to 2020. The participants consisted of 90 women who were candidates for abdominal hysterectomy. Anthropometric indices and vitamin D, Zn, and FBS levels were measured before the surgery. These factors were compared in the two groups of women with and without infection using the independent t-test and Pearson correlation coefficient, and P<0.05 was statistically significant. Results: No significant relationship was found between vitamin D, Zn, and FBS levels and anthropometric indices except for body mass index (BMI) that had a significant negative relationship with vitamin D blood levels (r = -0.20 and P = 0.043) while a significant positive relationship with FBS levels (r= +30 and P = 0.036) in infected patients. Therefore, patients with a higher BMI showed lower vitamin D whereas higher FBS levels in the group with infection. Conclusions: In general, vitamin D levels decreased and FBS levels increased by an increase in the BMI. These factors altogether increased the risk of postoperative infection following abdominal hysterectomy.

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Section: Laboratory Testssupporting

confidence: 93%

Assessment of the Relationship of Anthropometric Indices With Vitamin D, Zinc, and Fasting Blood Sugar Levels in Women With and Without Infection Following Abdominal Hysterectomy: A Case-Control Study

Mousavi

Osquee

Haghdoost

2020

International Journal of Women’s Health and Reproduction Scienc

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“…[21][22][23][24][25][26][27][28] Age, BMI, diabetes and indication for surgery have all been shown to influence complications. 11,25,27,[29][30][31] Uterine weight has also been shown to influence outcomes; 11,29,32 however, we did not include it because it would not be available preoperatively. The gynecologic diagnoses were chosen as they represent most benign indications at the time of hysterectomy.…”

Section: Predictorsmentioning

confidence: 99%

“…29 We identified clinical predictors for conversion from ICD-10 codes for obesity and diabetes. 31 Common gynecologic diagnoses recorded at the time of hysterectomy were identified from ICD-10 codes and include fibroids, menstrual disorders, endometri osis and pain, adenomyosis and benign adnexal mass. Women may have more than 1 gynecologic diagnosis at the time of hysterectomy.…”

Section: Predictorsmentioning

confidence: 99%

“…These specific codes have not been validated, although they have been used in several previous analyses. 3,19,31,33,40,41 Previous validation studies of HES coding have shown acceptable reliability, [42][43][44] and a 2012 systematic review reported that the the accuracy of diagnostic coding using HES data was 83%-96%. 45 A full list of codes and their description that we used to formulate these predictors can be found in Appendix 1, Supplementary Table 6.…”

Section: Predictorsmentioning

confidence: 99%

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Predicting major complications in patients undergoing laparoscopic and open hysterectomy for benign indications

Madhvani

Garcia

Zamora

et al. 2022

CMAJ

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Background: Hysterectomy, the most common gynecological operation, requires surgeons to counsel women about their operative risks. We aimed to develop and validate multivariable logistic regression models to predict major complications of laparoscopic or abdominal hysterectomy for benign conditions. Methods: We obtained routinely collected health administrative data from the English National Health Service (NHS) from 2011 to 2018. We defined major complications based on core outcomes for postoperative complications including ureteric, gastrointestinal and vascular injury, and wound complications. We specified 11 predictors a priori. We used internal–external cross-validation to evaluate discrimination and calibration across 7 NHS regions in the development cohort. We validated the final models using data from an additional NHS region. Results: We found that major complications occurred in 4.4% (3037/68 599) of laparoscopic and 4.9% (6201/125 971) of abdominal hysterectomies. Our models showed consistent discrimination in the development cohort (laparoscopic, C-statistic 0.61, 95% confidence interval [CI] 0.60 to 0.62; abdominal, C-statistic 0.67, 95% CI 0.64 to 0.70) and similar or better discrimination in the validation cohort (laparoscopic, C-statistic 0.67, 95% CI 0.65 to 0.69; abdominal, C-statistic 0.67, 95% CI 0.65 to 0.69). Adhesions were most predictive of complications in both models (laparoscopic, odds ratio [OR] 1.92, 95% CI 1.73 to 2.13; abdominal, OR 2.46, 95% CI 2.27 to 2.66). Other factors predictive of complications included adenomyosis in the laparoscopic model, and Asian ethnicity and diabetes in the abdominal model. Protective factors included age and diagnoses of menstrual disorders or benign adnexal mass in both models and diagnosis of fibroids in the abdominal model. Interpretation: Personalized risk estimates from these models, which showed moderate discrimination, can inform clinical decision-making for people with benign conditions who may require hysterectomy.

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“…As a matter of fact, numerous studies have shown that frailty, a syndrome that is characterised by the loss of biological reserves and mounting failure of homeostatic mechanisms and that manifests mainly in the elderly, is often The positive association in our analysis between diabetes and donor-site complications is backed by the literature. A number of publications assert a positive association between diabetes and postoperative complications in different abdominal surgeries [31,32]. This is hardly surprising, since metabolic syndrome-a constellation of hyperglycaemia, hypertension, dyslipoproteinemia, and truncal obesity-is considered an important risk factor for morbidity and has not without reason been nicknamed "the deadly quartet" [33].…”

Section: Donor-site Complications: Presumed Causes and Impactmentioning

confidence: 99%

The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction

Meyer

Handschin

Boll

et al. 2020

JCM

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Microsurgical abdominally-based reconstruction is considered the gold standard in autologous breast reconstruction. Despite refined surgical procedures, donor-site complications still occur, reducing patient satisfaction and quality of life. Recent work has outlined the potential of morphometric measurements in risk assessment for postoperative hernia development. With rising demand for personalised treatment, the goal of this study was to investigate their potential in risk assessment for any donor site complication. In this retrospective cohort study, 90 patients were included who each received microsurgical breast reconstruction at the hands of one surgeon between January 2015 and May 2017. Donor-site complications formed the primary outcome and were classified according to Clavien–Dindo. Morphometric measurements were taken on a routinely performed computed tomographic angiogram. Complications occurred in 13 of the 90 (14.4%) cases studied. All patients who developed any type of postoperative donor site complication had a history of abdominal surgery. The risk of postoperative complications increased by 3% with every square centimetre of omental fat tissue (OR 1.03, 95% CI 1.00–1.06, and p-value = 0.022). Morphometric measurements provide valuable information in risk assessment for donor-site complications in abdominally-based breast reconstruction. They may help identify personalised reconstructive options for maximal postoperative patient satisfaction and quality of life.

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Impact of Diabetes Mellitus on Postoperative Complications Following Laparoscopic Hysterectomy for Benign Indications

Cited by 14 publications

References 16 publications

Assessment of the Relationship of Anthropometric Indices With Vitamin D, Zinc, and Fasting Blood Sugar Levels in Women With and Without Infection Following Abdominal Hysterectomy: A Case-Control Study

Assessment of the Relationship of Anthropometric Indices With Vitamin D, Zinc, and Fasting Blood Sugar Levels in Women With and Without Infection Following Abdominal Hysterectomy: A Case-Control Study

Predicting major complications in patients undergoing laparoscopic and open hysterectomy for benign indications

The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction

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