TY - JOUR
T1 - Total laparoscopic hysterectomy
T2 - Body mass index and outcomes
AU - O'Hanlan, Katherine A.
AU - Lopez, Lisbeth
AU - Dibble, Suzanne L.
AU - Garnier, Anne Caroline
AU - Huang, Gloria Shining
AU - Leuchtenberger, Mirjam
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2003/12
Y1 - 2003/12
N2 - OBJECTIVE: This retrospective review of patients undergoing total laparoscopic hysterectomy examines whether differences in outcomes exist on the basis of body mass index (BMI). METHODS: All cases of total laparoscopic hysterectomy performed from September 1996 to July 2002 for benign diagnoses, and microinvasive cervical, early endometrial, and occult ovarian carcinoma were reviewed. There were 330 patients analyzed by BMI category (range, 18.5-54.1): ideal (n = 150) less than 24.9 kg/m2, overweight (n = 95) 25 to 29.9 kg/m2, and obese (n = 78) 30 kg/m2 or more. Seven patients were converted to laparotomy (four ideal BMI, two overweight, one obese) leaving 323 (98%) for analysis. Mean age (50 years), height (65 in.), and parity (1.2) were similar, with 39% nulligravidas in each group. RESULTS: Mean operating time (156 minutes), blood loss (160 mL), and length of hospital stay (1.9 days) did not vary by BMI group. Total complication rates (8.9%), and major (5.5%) and minor (3.4%) complication rates were similar in each BMI group. Urologic injury was observed in 3.1%, with two-thirds occurring in the first one-third of the patient series. CONCLUSION: Total laparoscopic hysterectomy is feasible and safe, resulting in short hospital stay, minimal blood loss, and minimal operating time for patients in all BMI groups. The laparoscopic approach may extend the benefits of minimally invasive hysterectomy to the very obese, for whom abdominal surgery poses serious risk.
AB - OBJECTIVE: This retrospective review of patients undergoing total laparoscopic hysterectomy examines whether differences in outcomes exist on the basis of body mass index (BMI). METHODS: All cases of total laparoscopic hysterectomy performed from September 1996 to July 2002 for benign diagnoses, and microinvasive cervical, early endometrial, and occult ovarian carcinoma were reviewed. There were 330 patients analyzed by BMI category (range, 18.5-54.1): ideal (n = 150) less than 24.9 kg/m2, overweight (n = 95) 25 to 29.9 kg/m2, and obese (n = 78) 30 kg/m2 or more. Seven patients were converted to laparotomy (four ideal BMI, two overweight, one obese) leaving 323 (98%) for analysis. Mean age (50 years), height (65 in.), and parity (1.2) were similar, with 39% nulligravidas in each group. RESULTS: Mean operating time (156 minutes), blood loss (160 mL), and length of hospital stay (1.9 days) did not vary by BMI group. Total complication rates (8.9%), and major (5.5%) and minor (3.4%) complication rates were similar in each BMI group. Urologic injury was observed in 3.1%, with two-thirds occurring in the first one-third of the patient series. CONCLUSION: Total laparoscopic hysterectomy is feasible and safe, resulting in short hospital stay, minimal blood loss, and minimal operating time for patients in all BMI groups. The laparoscopic approach may extend the benefits of minimally invasive hysterectomy to the very obese, for whom abdominal surgery poses serious risk.
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U2 - 10.1016/j.obstetgynecol.2003.08.018
DO - 10.1016/j.obstetgynecol.2003.08.018
M3 - Article
C2 - 14662231
AN - SCOPUS:0344687421
SN - 0029-7844
VL - 102
SP - 1384
EP - 1392
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 6
ER -