Influence of previous abdominal surgery on clinical outcomes of patients undergoing total laparoscopic hysterectomy
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Objective To evaluate the potential effects of previous abdominal surgery on post-operative outcome and incidence ofcomplications after total laparoscopic hysterectomy (TLH). Methods Between June 2008 and December 2016, 331 patients who underwent TLH were retrospectively reviewed. Participating patients were divided into 2 groups according to previous abdominal surgery. We compared the 2groups based on estimated blood loss, operation time, hospital stay, surgery-related complications, and conversion tolaparotomy rates. Results Group 1 included patients without a history of abdominal surgery (n=186), group 2 included patients with a historyof abdominal surgery (n=145). The complication rate was 3.2% in group 1 and 2.8% in group 2. Other post-operativeoutcome and complications such as estimated blood loss, hospital stay and conversion to laparotomy rates did notdiffer significantly between groups. Adhesiolysis was significantly more common in group 2 (P<0.001) and operationtime was significantly longer in the group 2 (P=0.004). The rate of conversion to laparotomy was higher in group 2, butthis difference was not significant (P=0.115). Group 2 patients were divided into subgroups according to the numberof surgery. In subgroups analysis of group 2, there were 70 patients who had one previous abdominal surgery and 75patients who had 2 or more previous surgeries. Moreover, there were significant differences in adhesiolysis (P=0.004)and conversion to laparotomy (P=0.034). There were no significant differences in other complications observed uponsubgroup analysis. Conclusion TLH can be conducted successfully regardless of previous abdominal surgery. Patients with previous abdominal surgeryare suitable and feasible candidates for TLH.
Abstract
Objective To evaluate the potential effects of previous abdominal surgery on post-operative outcome and incidence ofcomplications after total laparoscopic hysterectomy (TLH). Methods Between June 2008 and December 2016, 331 patients who underwent TLH were retrospectively reviewed. Participating patients were divided into 2 groups according to previous abdominal surgery. We compared the 2groups based on estimated blood loss, operation time, hospital stay, surgery-related complications, and conversion tolaparotomy rates. Results Group 1 included patients without a history of abdominal surgery (n=186), group 2 included patients with a historyof abdominal surgery (n=145). The complication rate was 3.2% in group 1 and 2.8% in group 2. Other post-operativeoutcome and complications such as estimated blood loss, hospital stay and conversion to laparotomy rates did notdiffer significantly between groups. Adhesiolysis was significantly more common in group 2 (P<0.001) and operationtime was significantly longer in the group 2 (P=0.004). The rate of conversion to laparotomy was higher in group 2, butthis difference was not significant (P=0.115). Group 2 patients were divided into subgroups according to the numberof surgery. In subgroups analysis of group 2, there were 70 patients who had one previous abdominal surgery and 75patients who had 2 or more previous surgeries. Moreover, there were significant differences in adhesiolysis (P=0.004)and conversion to laparotomy (P=0.034). There were no significant differences in other complications observed uponsubgroup analysis. Conclusion TLH can be conducted successfully regardless of previous abdominal surgery. Patients with previous abdominal surgeryare suitable and feasible candidates for TLH.
참고문헌 (21)
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