Introduction
Hysterectomy is one of the leading gynecological surgeries performed worldwide. Abdominal, vaginal, laparoscopic, laparoscopy assisted vaginal and robotic routes can be used. Minimally invasive approaches are given preference because of rapid recovery period and positive cosmetic outcomes.
When benign gynecologic indications is considered, ratio of total laparoscopic hysterectomy is seen to be increased [1]. In a recent study from U.K. it is shown that in the past 7 years, ratio of laparoscopic hysterectomy rised from 16% to 47% while abdominal hysterectomy ratio decreased from 73% to 46% within all hysterectomies performed [2]. Safety of laparoscopic surgery in the treatment of endometrial cancers has been disclosed in a recent multicentric randomized trial; result of this trial has shown that the overall and disease free survival of both laparoscopic and open surgery is similiar [3]. Nevertheless, after FDA declaration about risk of upstaging malign disease after morcellation, a slight decrease of 5.8% has been stated [4].
Beside advantages of minimally invasive surgery there is also some intra and postooperative complications.A national study from Japan has noted the postoperative complication rate of laparoscopic hysterectomy as 2.3% [5].
The objective of this retrospective observational study is to analyse the properties of laparoscopic hysterectomy cases that are performed for benign indications and also endometrial cancer indications. Operation time, postoperative complicaton rate, blood transfusion need, and hospitalization time are compared according to benign and malign indications and also body mass index of the patients.
Section snippets
Materials and method
Patients who were operated between September 2012 and December 2017 are included in this study. Patients’ age, body mass index, medical histories, operation indications, operation time, pathology reports, pre and postoperative hemoglobine values and postoperative complications are obtained from medical records.Body mass index is classified as underweight for <19; normal for 19–25 ; overweight for 25–30 and obese for ≥30.
All of the operations are performed by 5 experienced surgeons who used the
Results
Six hundred thirty five laparoscopic hysterectomy procedures were performed between September 2012 – December 2017 by gyne-oncology department in our institute. Mean age of patients were 52 ± 9.6 (min:30–max:87).Mean age was 50.7(±9.0) and 58.3(±9.2) at benign and malign disease groups respectively (p:0.000).Five hundred twenty eight patients’ body mass index measurements were available and mean BMI was 30.1 ± 6.5. Mean BMI of benign gynecologic disease group was 29.3 whereas this value was 32.8
Dıscussion
Minimal invasive surgical techniques are being widely used in benign and malign gynecologic operations. A recent study from U.K. denoted the laparoscopy as the mostly preferred surgical route for hysterectomy [6]. Laparoscopic approach is also the leading surgical route especially for benign gynecologic indications in our center.
In a recent study ; operation time and perioperative complication rates were found to be higher in patients with higher BMI who had laparoscopic hysterectomy whereas
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