Intraoperative Bowel Injury During Hysterectomy

Barouhas, Ivana; Mouhayar, Youssef; Stephan, Jean-Marie

doi:10.1089/gyn.2020.0230

Cited by 1 publication

(1 citation statement)

References 14 publications

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“…(4) Although rare, major complications such as hemorrhage, bowel or urinary tract injuries and vaginal cuff dehiscence still arise and often require additional surgical or pharmacological interventions, resulting in higher morbidity and mortality risks. (5)(6)(7) Risk factors for complications include multiple surgeon and center-specific factors. Surgeon volume has repeatedly been found to be a predictive factor, as surgeries performed by high-volume surgeons are usually associated with shorter hospitalizations, fewer perioperative complications, and fewer conversions to laparotomy.…”

Section: Introductionmentioning

confidence: 99%

Major Perioperative Complications of Benign Gynecologic Procedures at a University-Affiliated Hospital

Busque

Belzile²,

Rodrigues

et al. 2022

McGill J Med

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Background: With the increasing use of minimally invasive techniques for gynecologic procedures, women are at a low risk for peri-operative complications. The purpose of this study was to determine the incidence of and risk factors for major intra or postoperative complications among women undergoing benign gynecologic surgeries. Methods: We conducted a retrospective observational study of all women who underwent benign gynecologic surgery in 2016-2017 at a University-Affiliated community hospital. Pregnant women, malignancy cases, and hysteroscopic or minor vulvar procedures were excluded. Primary outcome was composite intraoperative and/or 30-day postoperative complications requiring medical or surgical management. Logistic regression identified significant patient, peri-operative and surgeon risk factors associated with complications. Results: Of 975 patients included, 53 patients experienced major intra or postoperative complications (5.4%). Mean age was 47.7 ± 13.8 years. Mean BMI was 27.1 ± 5.8 kg/m2. Prior abdominal surgery (laparotomy or laparoscopy) (adjusted odds ratio [OR]= 2.01, 95%CI 1.05-3.83) and emergency surgery (adjusted OR= 19.54, 95%CI 2.99-127.54) were significantly associated with major complications. Surgeon volume of 1-2 operative days per month (adjusted OR=0.30, 95%CI 0.10 - 0.87) and age 40-64 years (adjusted OR=0.24, 95%CI 0.11- 0.56) had a protective effect on the risk of major complications. Conclusions: Among patients in our sample, 5.4% experienced major complications from a benign gynecologic surgery. Complications from benign gynecologic surgery are rare, even in the absence of robotic equipment. Center-specific data and a discussion of the increased morbidity associated with with prior abdominal surgery and emergency surgery should be considered for pre-operative patient counselling.

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Section: Introductionmentioning

confidence: 99%