Complications of laparoscopic hysterectomy: search for risk factors


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Abstract

Objective: To identify risk factors of complications after laparoscopic hysterectomy. Materials and methods: The study enrolled 87 patients who underwent endoscopic total hysterectomy for uterine fibroids and adenomyosis. Of these, vaginal cuff closure was performed by transvaginal sutures (n=54, 62.1%) or intracorporeal sutures (n=33, 37.9%). Results: Total vaginal cuff dehiscence was observed in 11 cases, of which 10 cases manifested by bleeding and one by eventration. Infectious complications were registered in five cases including two surgical site (ICSS) infections, two peritonitis, and one peritonitis concurrent with ICSS. The following risk factors for complications after laparoscopic hysterectomy were established: reproductive age, adenomyosis, obesity, respiratory diseases, transvaginal vaginal cuff suture, subcompensated or decompensated blood flow in the vaginal branch of the uterine artery (IR≥0.8) or its absence on the 2nd day after surgery and leukocyte intoxication index ≥2 on the 3rd day after surgery. Conclusion: Identification of risk factors for complications after laparoscopic hysterectomy will prevent patients from re-hospitalization by optimizing pre-surgical planning of surgical access, choosing method of vaginal cuff closure, and determination of terms of discharge.

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About the authors

Oleg A. Volkov

Novokuznetsk State Institute for Advanced Medical Studies, branch of Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia; Group of companies "Mother and Child Siberia"

Email: o.volkov@mcclinics.ru
MD, Teaching Assistant, Department of Obstetrics and Gynecology

Svetlana V. Shramko

Novokuznetsk State Institute for Advanced Medical Studies, branch of Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia

Email: shramko_08@mail.ru
Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology

Ludmila V. Renge

Novokuznetsk State Institute for Advanced Medical Studies, branch of Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia

Email: l.renge@mail.ru
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology

Polina E. Saltykova

Novokuznetsk State Institute for Advanced Medical Studies, branch of Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia

Email: urtica66@gmail.com
MD, Teaching Assistant at the Department of Obstetrics and Gynecology

Maxim A. Sabantsev

G.P. Kurbatov Novokuznetsk City Clinical Hospital No.1

Email: dr.sabantsev@ya.ru
MD, Head of Gynecological Department

Evgenia Yu. Shisheya

G.P. Kurbatov Novokuznetsk City Clinical Hospital No.1

Email: shisheya@mail.ru
MD, Head of the Department of Selective Obstetrical and Gynecological Surgery No.l

Elena Yu. Koval

G.P. Kurbatov Novokuznetsk City Clinical Hospital No.1

Email: covalan@mail.ru
MD, Gynecological Surgeon

Anna E. Vlasenko

Novokuznetsk State Institute for Advanced Medical Studies, branch of Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia

Email: vlasenkoanna@inbox.ru
Specialist at the Department of Medical Statistics and Informatics

Ekaterina A. Chubar

Novokuznetsk State Institute for Advanced Medical Studies, branch of Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia

Email: ekaterina.chubar.96@mail.ru
Resident at the Gynecological Department

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