Postoperative outcomes in minimally invasive total versus supracervical hysterectomy for endometriosis: a NSQIP study.

IF 2.1 3区医学 Q2 OBSTETRICS & GYNECOLOGY Archives of Gynecology and Obstetrics Pub Date : 2024-10-16 DOI:10.1007/s00404-024-07749-y

Raanan Meyer, Jill McDonnell, Kacey M Hamilton, Rebecca J Schneyer, Gabriel Levin, Kelly N Wright, Matthew T Siedhoff

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Abstract

Purpose: To study the rate and odds of 30 day postoperative complications among patients undergoing minimally invasive total (TLH) compared to supracervical (LSCH) hysterectomy for endometriosis.

Study design: A cohort study of patients with a diagnosis of endometriosis undergoing hysterectomy. We used prospectively collected data from the American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2020. We compared short-term (30 day) complications, following minimally invasive TLH and LSCH for endometriosis. The primary outcome was the risk of any postoperative complications according to the surgical approach.

Results: A total of 5,278 patients were included, 4,952 (93.8%) underwent TLH and 326 (6.2%) underwent LSCH. The incidence of any complication was significantly lower in the LSCH group compared to the TLH group (3.7% vs. 8.5%, p = .001). Both major complications (1.5% vs. 3.7%, p = 0.043) and minor complications (2.8% vs. 5.4%, p = .039) were less frequent in the LSCH group compared to the TLH group. In multivariable regression analysis, patients undergoing LSCH had significantly lower odds of any complication [aOR 95%CI 0.40 (0.22-0.72)], and of minor complications [aOR 95%CI 0.47 (0.24-0.92)] compared to TLH.

Conclusions: LSCH is associated with a lower odd of short-term postoperative complications compared to TLH for patients with endometriosis.

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子宫内膜异位症微创全子宫切除术与宫颈上位术的术后效果：NSQIP 研究。

目的：研究因子宫内膜异位症而接受微创全子宫切除术（TLH）与宫颈上子宫切除术（LSCH）的患者术后30天并发症的发生率和几率：研究设计：对确诊患有子宫内膜异位症并接受子宫切除术的患者进行队列研究。我们使用了从美国外科学院国家手术质量改进计划数据库中收集的 2012 年至 2020 年的前瞻性数据。我们比较了微创 TLH 和 LSCH 治疗子宫内膜异位症后的短期（30 天）并发症。主要结果是根据手术方法的不同，术后并发症的风险也不同：共纳入了 5278 名患者，其中 4952 人（93.8%）接受了 TLH，326 人（6.2%）接受了 LSCH。与TLH组相比，LSCH组任何并发症的发生率都明显较低（3.7% vs. 8.5%，P = .001）。与TLH组相比，LSCH组的主要并发症（1.5% vs. 3.7%，p = 0.043）和轻微并发症（2.8% vs. 5.4%，p = .039）发生率都较低。在多变量回归分析中，与TLH相比，接受LSCH的患者发生任何并发症[aOR 95%CI 0.40 (0.22-0.72)] 和轻微并发症[aOR 95%CI 0.47 (0.24-0.92)] 的几率明显较低：结论：对于子宫内膜异位症患者而言，与TLH相比，LSCH术后短期并发症的发生率较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Gynecology and Obstetrics 医学-妇产科学

CiteScore

4.70

自引率

15.40%

发文量

493

审稿时长

1 months

期刊介绍： Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.