Safety of total laparoscopic hysterectomy in patients with prior cesarean section

Lim, Seung Joo; Lee, Seungho; Choi, Jaewon; Chon, Seungjoo; Lee, Kwang-Beom; Shin, Jae-Sik

doi:10.1111/jog.13191

Cited by 12 publications

(11 citation statements)

References 25 publications

(60 reference statements)

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“…14,17,29,32,33 Ten of the remaining included studies assessed the odds of surgical complications following minimally invasive hysterectomy (laparoscopic-assisted vaginal hysterectomy, total laparoscopic hysterectomy, and roboticassisted hysterectomy) 16,[20][21][22][23]27,28,31,34,35 and 11 included studies assessed the odds of various types of hysterectomy including total abdominal hysterectomy and vaginal hysterectomy. 4,6,15,18,19,[24][25][26]30,36,37 Study designs of the included studies were cohort studies (24) 4,6,14-25,27-29,31-37 and case-control studies (two) 26,30 (Tables S3 and S4). Figure 2 shows the summary of the risk of biases stratified by the type of study design.…”

Section: Resultsmentioning

confidence: 99%

“…Figure 2 shows the summary of the risk of biases stratified by the type of study design. Quality assessment among 24 cohort studies using the Newcastle-Ottawa Scale indicated that high risks for comparability and outcome assessment were, respectively, noted in 15 [14][15][16][17][18][21][22][23][24][25]27,28,33,34,36 and 12 studies. 6,14,15,17,18,22,27,29,31,33,34,37 No cohort study was judged as having a high risk of selection bias.…”

Section: Resultsmentioning

confidence: 99%

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<p>Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis</p>

Rattanakanokchai¹,

Kietpeerakool²,

Srisomboon³

et al. 2019

CLEP

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Background: With increasing rates of cesarean sections (CS), the number of hysterectomies performed among women with a previous CS is on the rise. Objective: To provide the association between the odds of complications following a hysterectomy performed later in life and a previous CS. Search strategy: A comprehensive search was performed using major electronic databases, ie, MEDLINE, Scopus, ISI Web of Science, from their inception to April 2019. Selection criteria: Analytical studies, irrespective of language or publication status, were included. Data collection and analysis: Outcomes were extracted in duplicate. The methodological quality of the included studies was independently evaluated by two review authors. A threelevel meta-analysis was applied for outcomes with dependent effect sizes. Main results: Twenty-six studies were included involving 54,815 women. The odds of the following complications were increased in women with a previous CS: urinary tract injury (pooled unadjusted odds ratio (OR)=3.15, 95% CI=2.01-4.94, 15 studies, 33,902 women, and pooled adjusted OR=2.21, 95% CI=1.46-3.34, 3 studies, 31,038 women), gastrointestinal tract injury (pooled unadjusted OR=1.73, 95% CI=1.19-2.53; 7 studies, 30,050, and pooled adjusted OR=1.83, 95% CI=1.11-3.03, 1 study, 25,354 women), postoperative infections (pooled unadjusted OR=1.44, 95% CI=1.22-1.71, 6 studies, 37,832 women), wound complications (pooled unadjusted OR=2.24, 95% CI=1. 9 studies,37,559 women), reoperation (pooled unadjusted OR=1.46, 2 studies,9,899 women), and blood transfusion (pooled unadjusted OR=1.35, 95% CI=1.03-1.76, 7 studies, 13,430 women). Conclusion: Previous CS increases risks of various complications following hysterectomy. This information reminds the gynecologists to be aware of the associations between previous CS and potential complications among women undergoing hysterectomy. Prospero registration number: CRD42018085061.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

<p>Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis</p>

Rattanakanokchai¹,

Kietpeerakool²,

Srisomboon³

et al. 2019

CLEP

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“…In cases with previous CS, surgeons often refrain from performing vaginal and laparoscopic hysterectomies for fear of increasing the complication rates. 12,13 In a recent cohort study, it was revealed that patients with a history of CS carried a greater risk of hysterectomies over the long term. Moreover, compared with patients who have…”

Section: This Study Was Completed With 505 Patients Using Yada-mentioning

confidence: 99%

Characteristics of total laparoscopic hysterectomy among women with or without previous cesarean section: retrospective analysis

et al. 2018

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BACKGROUND: The number of hysterectomized patients with previous cesarean sections (CSs) has increased due to increasing CS rates. A previous history of CS has been demonstrated to be an important risk factor for major complications in total laparoscopic hysterectomy. The aim here was to evaluate the major complications and safety of TLH in patients with previous CS. DESIGN AND SETTING: Retrospective analysis in a tertiary-level center. METHODS: The medical records of 504 total laparoscopic hysterectomy patients operated between May 2013 and May 2017 were reviewed retrospectively. Data on age, parity, surgical indications, duration of operation, length of hospital stay, histopathological diagnosis and major intra and postoperative complications were gathered. The patients were categorized into two groups according to their CS history, namely those with and those without previous CS. Major complications were defined as the presence of lower urinary tract injury (bladder or ureter injury), enterotomy/colostomy, bowel serosal injury or vascular injury. RESULTS: There was no difference between the groups in terms of parity, duration of operation, hospital stay or pre and postoperative hemoglobin levels. The conversion rates to laparotomy in the previous CS and no CS groups were 2% and 1.7%, respectively. The rates of major complications in the previous CS and no CS groups were 5% and 1.3%, respectively, and these results did not differ significantly (P > 0.05). CONCLUSION: TLH could be performed safely in the previous CS group, since the complication rate was not different from that of the patients without previous CS.

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“…, above average haemorrhage (5), low or high body mass index (5), placental adhesion disorder (4), concomitant surgery (4) and emergency procedure (2). Note that "surgeon inexperience or low volume" was self-defined by each study, and included undefined [28,34,49,50,59,62,77,78,93,96], a surgical trainee [97], a consultant with <8 years' experience [41] or having been primary operator for a given hysterectomy approach for fewer than 20 [23], 30 [40,82], 50 [43,87] or 100 cases [57].…”

Section: Risk Factors For Urological Injurymentioning

confidence: 99%

Systematic review of urological injury during caesarean section and hysterectomy

et al. 2022

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Introduction and hypothesis We aim to review iatrogenic bladder and ureteric injuries sustained during caesarean section and hysterectomy. Methods A search of Cochrane, Embase, Medline and grey literature was performed using methods pre-published on PROSPERO. Eligible studies described iatrogenic bladder or ureter injury rates during caesarean section or hysterectomy. The 15 largest studies were included for each procedure sub-type and meta-analyses performed. The primary outcome was injury incidence. Secondary outcomes were risk factors and preventative measures. Results Ninety-six eligible studies were identified, representing 1,741,894 women. Amongst women undergoing caesarean section, weighted pooled rates of bladder or ureteric injury per 100,000 procedures were 267 or 9 events respectively. Injury rates during hysterectomy varied by approach and pathological condition. Weighted pooled mean rates for bladder injury were 212–997 events per 100,000 procedures for all approaches (open, vaginal, laparoscopic, laparoscopically assisted vaginal and robot assisted) and all pathological conditions (benign, malignant, any), except for open peripartum hysterectomy (6,279 events) and laparoscopic hysterectomy for malignancy (1,553 events). Similarly, weighted pooled mean rates for ureteric injury were 9–577 events per 100,000 procedures for all hysterectomy approaches and pathologies, except for open peripartum hysterectomy (666 events) and laparoscopic hysterectomy for malignancy (814 events). Surgeon inexperience was the prime risk factor for injury, and improved anatomical knowledge the leading preventative strategy. Conclusions Caesarean section and most types of hysterectomy carry low rates of urological injury. Obstetricians and gynaecologists should counsel the patient for her individual risk of injury, prospectively establish risk factors and implement preventative strategies.

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Safety of total laparoscopic hysterectomy in patients with prior cesarean section

Abstract: TLH in patients with a history of CS can be performed safely as such history had no effect on the major complication rate. Complications were rare and were treated successfully.

Cited by 12 publications

References 25 publications

<p>Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis</p>

<p>Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis</p>

Characteristics of total laparoscopic hysterectomy among women with or without previous cesarean section: retrospective analysis

Systematic review of urological injury during caesarean section and hysterectomy

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