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. 2023;83(5):727-736.

[Single-center cohort study of perioperative outcomes on total laparoscopic hysterectomy (TLH): a 10-year experience]

[Article in Spanish]
Agustina S Naessens Aspiazu  1 , Renata Vassolo  2 , Agustina A Márquez  2 , Justina P Brown  2 , Guido O Vietri  2 , Diego Odetto  3
Affiliations
  • PMID: 37870330
Free article

[Single-center cohort study of perioperative outcomes on total laparoscopic hysterectomy (TLH): a 10-year experience]

[Article in Spanish]
Agustina S Naessens Aspiazu et al. Medicina (B Aires). 2023.
Free article

Abstract
in English, Spanish

Introduction: The removal of the uterus, (hysterectomy), is the most frequent surgery in gynecology. In Argentina there are few publications on the perioperative results of this type of procedure, and even less on minimally invasive hysterectomy. The objective of this study was to determine the rate of perioperative complications in patients with total laparoscopic hysterectomy performed at Hospital Italiano de Buenos Aires, from January 7, 2010 to December 22, 2020.

Methods: retrospective cohort study where electronic medical records were reviewed. Intrasurgical and postoperative complications were evaluated using the validated Clavien-Dindo's classification.

Results: 1014 patients were included. The rate of intra-surgical complications was 4.5%. In respect to postoperative complications, there was found a rate of 16.6% (n=168), being 12.3% (n=125) Clavien-Dindo = 2, and 4.2% (n=43) Clavien-Dindo = 3. In a multivariable analysis that adjusted for uterine weight > 170g, age, body mass index, and more than two previous abdominal surgeries, an association was found between uterine weight >170g and postoperative complications OR 1.49, 95% CI 1.04- 2.14, p=0.03.

Discussion: When evaluating the percentage of minor and major complications, our findings are within the acceptable parameters for performing this type of surgery, even though the evaluation was carried out in an educational setting.

Introducción: La extirpación del útero, (histerectomía) es la cirugía más frecuente en ginecología. En Argentina existen pocas publicaciones sobre los resultados perioperatorios de este tipo de procedimiento, y menos aún sobre histerectomía mínimamente invasiva. El objetivo de este estudio fue determinar la tasa de complicaciones perioperatorias en pacientes con histerectomía total laparoscópica realizada en el Hospital Italiano de Buenos Aires, desde el 7 de enero de 2010 al 22 de diciembre de 2020. Métodos: estudio de cohorte retrospectivo donde se revisaron las historias clínicas electrónicas de pacientes sometidas a una histerectomía laparoscópica en el período mencionado. Se evaluaron las complicaciones intraquirúrgicas y postoperatorias utilizando la clasificación validada de Clavien-Dindo. Resultados: Se incluyeron 1014 pacientes. La tasa de complicaciones intraquirúrgicas fue de 4.5%. Se halló una tasa de complicaciones postoperatorias de 16.6% (n=168), siendo 12.3% (n=125) Clavien-Dindo = 2, y 4.2% (n=43) Clavien-Dindo = 3. En el análisis multivariable que se ajustó por peso uterino >170g, edad, índice de masa corporal y más de dos cirugías abdominales previas, se encontró asociación entre peso uterino > 170 g y complicaciones postoperatorias, OR 1.49, IC 95% 1.04-2.14, p = 0.03. Discusión: Al evaluar el porcentaje de complicaciones menores y mayores, nuestros números se encuentran dentro de los parámetros aceptables para realizar este tipo de cirugía, más aún, considerando que la evaluación se realizó en un ámbito educativo.

Keywords: hysterectomy; intraoperative complications; laparoscopy; postoperative complications.

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