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Mutter, Olga; Ackroyd, Sarah; Taylor, George A; Diaz, Juan

Surgical outcomes of hysterectomy for endometriosis: Benefits of a minimally invasive approach

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  • Medientyp: E-Artikel
  • Titel: Surgical outcomes of hysterectomy for endometriosis: Benefits of a minimally invasive approach
  • Beteiligte: Mutter, Olga; Ackroyd, Sarah; Taylor, George A; Diaz, Juan
  • Erschienen: SAGE Publications, 2021
  • Erschienen in: Journal of Endometriosis and Pelvic Pain Disorders
  • Sprache: Englisch
  • DOI: 10.1177/2284026520985715
  • ISSN: 2284-0265; 2284-0273
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Introduction:</jats:title><jats:p> We aimed to evaluate surgical outcomes of hysterectomy for endometriosis performed by general obstetricians and gynecologists (OB/GYNs) based on surgical approach. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Using the 2016–2018 National Surgical Quality Improvement Program (NSQIP) database, we examined surgical outcomes including 30-day complication rates based on surgical approach in patients who underwent a hysterectomy for endometriosis by OB/GYNs. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> From 2016 to 2018, 3641 hysterectomies were performed by OB/GYNs for endometriosis. 86.0% were performed via a minimally invasive (MIS) approach, with 2882 (79.2%) via a laparoscopic and 247 (6.8%) via a vaginal approach. Compared to MIS hysterectomies, those who underwent an abdominal hysterectomy included a higher proportion of African American and a lower proportion of non-Hispanic white patients, had heavier uteri, lower parity, and were more likely obese (all p &lt; 0.05). There were no differences in age, American Society of Anesthesiologists class, comorbidities other than obesity, or a history of prior abdominal or pelvic surgery (all p &gt; 0.05). Women undergoing hysterectomy for endometriosis experienced an overall 9.8% complication rate. Compared to abdominal approaches, MIS had a lower rate of overall complications (8.5% vs 17.8%) including wound (2.7% vs 7.2%) and major (4.4% vs 8.8%) complications (all p &lt; 0.001). MIS had shorter operative time (129.2 ± 60.9 vs 143.8 ± 71.9), shorter length of stay (0.9 ± 1.6 vs 2.4 ± 1.8), and fewer readmissions (2.8% vs 5.5%) (all p &lt; 0.001). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> While hysterectomy for endometriosis is a challenging procedure to perform, OB/GYNs are performing this procedure predominantly via a minimally invasive approach with fewer complications and more favorable surgical outcomes than an abdominal approach. </jats:p></jats:sec>