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

Autor: Radosa JC; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany. Julia.radosa@uks.eu., Radosa MP; Department of Gynecology and Obstetrics, Klinikum Bremen-Nord, Bremen, Germany., Zimmermann JSM; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany., Braun EM; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany., Findeklee S; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany., Wieczorek A; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany., Stotz L; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany., Hamza A; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany., Takacs FZ; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany., Risius UM; Department of Business and Psychology, University of Applied Sciences Europe, Berlin, Germany., Gerlinger C; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany., Radosa CG; Department of Radiology, Dresden University Hospital, Dresden, Germany., Wagenpfeil S; Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University Hospital, Homburg, Saar, Germany., Solomayer EF; Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2021 Aug; Vol. 304 (2), pp. 447-454. Date of Electronic Publication: 2021 May 03.
DOI: 10.1007/s00404-021-06064-0
Abstrakt: 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.
(© 2021. The Author(s).)
Databáze: MEDLINE
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