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. 2021 Aug;304(2):447-454.
doi: 10.1007/s00404-021-06064-0. Epub 2021 May 3.

Incidence of and risk factors for vaginal cuff dehiscence following total laparoscopic hysterectomy: a monocentric hospital analysis

Julia Caroline Radosa  1 , Marc Philipp Radosa  2 , Julia Sarah Maria Zimmermann  3 , Eva-Marie Braun  3 , Sebastian Findeklee  3 , Annette Wieczorek  3 , Lisa Stotz  3 , Amr Hamza  3 , Ferenc Zoltan Takacs  3 , Uda Mareke Risius  4 , Christoph Gerlinger  3 , Christoph Georg Radosa  5 , Stefan Wagenpfeil  6 , Erich-Franz Solomayer  3
Affiliations

Incidence of and risk factors for vaginal cuff dehiscence following total laparoscopic hysterectomy: a monocentric hospital analysis

Julia Caroline Radosa et al. Arch Gynecol Obstet. 2021 Aug.

Abstract

Purpose: Vaginal cuff dehiscence (VCD) is one of the major surgical complications following hysterectomy with data on incidence rates varying largely and studies assessing risk factors being sparse with contradictive results. The aim of this study was to assess the incidence rate of and risk factors for VCD in a homogenous cohort of women treated for benign uterine pathologies via total laparoscopic hysterectomy (TLH) with standardized follow-up.

Methods: All patients undergoing TLH at the Department of Gynecology and Obstetrics, Saarland University Hospital between November 2010 and February 2019 were retrospectively identified from a prospectively maintained service database.

Results: VCD occurred in 18 (2.9%) of 617 patients included. In univariate and multivariate analyses, a lower level of surgeon laparoscopic expertise (odds ratio 3.19, 95% confidence interval (CI) 1.0-9.38; p = 0.03) and lower weight of removed uterus (odds ratio 0.99, 95% CI 0.98-0.99; p = 0.02) were associated positively with the risk of VCD.

Conclusion: In this homogenous cohort undergoing TLH, laparoscopic expertise and uterine weight influenced the risk of postoperative VCD. These findings might help to further reduce the rate of this complication.

Keywords: Complication; Gynecologic surgery; Laparoscopic surgery; Risk factors; Total laparoscopic hysterectomy; Vaginal cuff dehiscence.

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Conflict of interest statement

Dr. Julia Caroline Radosa, Dr. Christoph Gerlinger, Dr. Lisa Stotz, Professor Dr. Stefan Wagenpfeil and Professor Dr. Erich–Franz Solomayer declare no conflict of interest regarding the submitted work. Regarding interactions outside the submitted work, Dr. Julia Radosa has received travel grants from Medac GmbH (Wedel, Germany), Gedeon Richter (Budapest, Hungary), and Celgene (Summit, USA), Daiichi Sankyo (Tokyo, Japan), Pfizer (New York City, USA) and was an honorary speaker for Pfizer (New York City, USA) in the past. Dr. Lisa Stotz has received travel grants from Medac GmbH (Wedel, Germany) and Celgene (Summit, USA) outside the submitted work in the past. Dr. Christoph Gerlinger is a full-time employee of Bayer AG (Berlin, Germany). Professor Dr. Stefan Wagenpfeil is receiving grants from Saarland University (Saarbruecken, Germany) and Servier (Suresnes Cedex, France) outside the submitted work. Professor Dr. Erich–Franz Solomayer is receiving grants from the University of Saarland, Storz, and Erbe; personal fees and other compensation from Roche (Basel, Switzerland), Pfizer (New York City, USA), Celgene (Summit USA), Amgen (Thousand Oaks, USA), and Astra Zeneca (Cambridge, GB); other fees from Johnson & Johnson (New Brunswick, USA), Novartis (Basel, Switzerland), Tesaro (Waltham, USA), Medac GmbH (Wedel, Germany), MSD (Kenilworth, USA), Vifor (Sankt Gallen, Switzerland), Gedeon Richter (Budapest, Hungary), Takeda (Tokyo, Japan), and AGE (Buchholz, Germany) outside the submitted work. Dr. Marc Philipp Radosa, Dr. Eva-Marie Braun, Dr. Sebastian Findeklee, Dr. Annette Wieczorek, Dr. Julia Zimmermann, Dr. Amr Hamza, Dr. Ferenc Zoltan Takacs, Professor Dr. Uda Mareke Risius and Dr. Christoph Radosa declare no potential conflict of interest regarding the submitted work and outside the submitted work.

Figures

Fig. 1
Fig. 1
Different portio caps used for total laparoscopic hysterectomy ((1)–32 mm, (2)–35 mm, and (3)–40 mm)
See this image and copyright information in PMC

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