Perioperative Complications of Laparoscopic Versus Open Surgery for Pelvic Inflammatory Disease
| Autor: | Megan Billow, Sonia Carlson, Sadhvi Batra, Sherif A. El-Nashar, Graham C. Chapman |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Hysterectomy Lower risk 03 medical and health sciences Postoperative Complications 0302 clinical medicine Interquartile range Pelvic inflammatory disease medicine Humans Laparoscopy Retrospective Studies 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Obstetrics and Gynecology Retrospective cohort study Perioperative Middle Aged United States Surgery 030220 oncology & carcinogenesis Cohort Female business Pelvic Inflammatory Disease |
| Zdroj: | Journal of Minimally Invasive Gynecology. 27:S82 |
| ISSN: | 1553-4650 |
| Popis: | STUDY OBJECTIVE To compare complications in patients undergoing laparoscopic vs open surgery for acute pelvic inflammatory disease (PID). DESIGN We performed a retrospective cohort study of patients who underwent surgery for PID, using the American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2015. Propensity score matching was used to balance baseline characteristics and compare complications in patients who underwent laparoscopic vs open surgery. SETTING Surgical management of acute PID. PATIENTS Patients with a preoperative diagnosis of PID were identified using International Classification of Diseases, Ninth Revision, codes. We excluded patients with chronic PID, gynecologic malignancy, and those for whom the surgical route was unknown. INTERVENTIONS Surgery for acute PID. MEASUREMENTS AND MAIN RESULTS The study included 367 patients. The mean age was 43.0 ± 11.1 years, body mass index was 30.9 ± 11.2 kg/m2, and American Society of Anesthesiology class was 2 (interquartile range 2-3). Preoperative signs of sepsis were noted in 33.8% of the patients, and septic shock was present in 1.4%. Hysterectomy was performed in 67.6%, oophorectomy in 12.0%, and salpingectomy in 4.6%. Complications were experienced by 114 patients (31.1%), 11 (3.0%) of which were potentially life-threatening. Multivariate logistic regression identified the following to be independently associated with complications: laparoscopy (adjusted odds ratio [aOR] 0.48; 95% confidence interval [CI], 0.3-0.8; p |
| Databáze: | OpenAIRE |
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