Peri- and postoperative outcomes in patients with endometriosis undergoing hysterectomy.

Abstract

OBJECTIVES:

To assess whether hysterectomy in patients with endometriosis is associated with higher proportion of complications compared with patients without, and whether route of hysterectomy affects this outcome.

STUDY DESIGN:

This is a population-based retrospective cohort study. Data were prospectively obtained from three National Swedish Registers. Patients undergoing a benign hysterectomy between 2015 and 2017 in Sweden were included in the study and were grouped according to a histology-proven diagnosis of endometriosis. Different hysterectomy modes were compared in patients with endometriosis. Perioperative data and postoperative complications up to 1 year after surgery were collected and measured.

RESULTS:

In all, 8,747 patients underwent a benign hysterectomy, and 1,166 patients with endometriosis was compared with 7,581 patients without. Patients with endometriosis had higher proportion of complications (adjusted Odds ratio aOR 1.2, 95% CI 1.0-1.4), were more often converted to abdominal hysterectomy (aOR 1.7, 95% CI 1.1-2.6), had higher estimated blood loss (EBL) (200-500 ml; aOR 1.8, 95% CI 1.4-2.3, >500 ml; aOR 3.1, 95% CI 2.2-4.4) and a longer operative time (1-2 h; aOR 2.1, 95% CI 1.4-3.2, >2 h; aOR 4.3, 95% CI 2.7-6.6) than endometriosis-free patients. The conversion rate was 13.8 times higher in total laparoscopic hysterectomy (TLH) compared with robotic-assisted laparoscopic hysterectomy (RATLH) (aOR 13.8, 95% CI 3.6-52.4).

CONCLUSION:

Higher conversion rate, higher EBL and higher frequency of complications were seen in patients with endometriosis. RATLH was associated with lower conversion rate compared to TLH.

• Authors: Malin Brunes, Ulrika Johannesson, Henrike Häbel, Catharina Forsgren, Gaby Moawad, Marion Ek
• Journal: European journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 272 Pg. 104-109 (May 2022) ISSN: 1872-7654 [Electronic] Ireland
• PMID: 35299012 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.

Topics

• Endometriosis (complications, surgery)
• Female
• Humans
• Hysterectomy (adverse effects)
• Laparoscopy (adverse effects)
• Postoperative Complications (epidemiology, etiology, surgery)
• Retrospective Studies