Postoperative outcomes in minimally invasive total versus supracervical hysterectomy for endometriosis: a NSQIP study.

Publication Title

Archives of gynecology and obstetrics

Document Type

Article

Publication Date

10-16-2024

Keywords

Complications; Laparoscopy; Pelvic pain; Robotic surgery.; washington; swedish

Abstract

PURPOSE: To study the rate and odds of 30 day postoperative complications among patients undergoing minimally invasive total (TLH) compared to supracervical (LSCH) hysterectomy for endometriosis.

STUDY DESIGN: A cohort study of patients with a diagnosis of endometriosis undergoing hysterectomy. We used prospectively collected data from the American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2020. We compared short-term (30 day) complications, following minimally invasive TLH and LSCH for endometriosis. The primary outcome was the risk of any postoperative complications according to the surgical approach.

RESULTS: A total of 5,278 patients were included, 4,952 (93.8%) underwent TLH and 326 (6.2%) underwent LSCH. The incidence of any complication was significantly lower in the LSCH group compared to the TLH group (3.7% vs. 8.5%, p = .001). Both major complications (1.5% vs. 3.7%, p = 0.043) and minor complications (2.8% vs. 5.4%, p = .039) were less frequent in the LSCH group compared to the TLH group. In multivariable regression analysis, patients undergoing LSCH had significantly lower odds of any complication [aOR 95%CI 0.40 (0.22-0.72)], and of minor complications [aOR 95%CI 0.47 (0.24-0.92)] compared to TLH.

CONCLUSIONS: LSCH is associated with a lower odd of short-term postoperative complications compared to TLH for patients with endometriosis.

Area of Special Interest

Women & Children

Specialty/Research Institute

Obstetrics & Gynecology

Specialty/Research Institute

Surgery

DOI

10.1007/s00404-024-07749-y

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