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• W4212828305 abstract "To determine if uterine weight greater than 250 grams increases perioperative morbidity in benign minimally invasive hysterectomy (MIH). We performed a retrospective cohort study of women who underwent MIH in a single academic hospital system between 2014 and 2021. Patients were identified via CPT codes for MIH: vaginal (VH), laparoscopic-assisted vaginal (LA-VH), and laparoscopic or robotic (Lsc-H). Exclusion criteria included a gynecologic cancer diagnosis, conversion to an open procedure, or concomitant major procedure at the time of hysterectomy. Uterine weight resulted on pathology report was analyzed as a categorical variable (<250g or >250g). Our primary outcome was a composite of surgical complications, operative time, and postoperative transfusion rate. Univariable analysis using non-parametric testing when appropriate and generalized linear regression were performed using STATA v15.0 (College Station, TX). A total of 1,556 patients were identified (1179 uteri <250g [76%] vs. 377 uteri >250g [24%]). There were no significant differences in route of hysterectomy between groups (488/1556 Lsc-H [31%], 953/1556 RA-LH [61%] and 115/1556 VH [7%], p <0.079). Patient demographics were similar except for significant differences in BMI (30.7±0.2 uteri <250g vs. 32.1±0.4 uteri >250g, p<0.002) and race with a greater percentage of black patients with uteri >250g (168/394, 17%) vs. white patients (174/998, 43%) and not otherwise specified (16/71, 23%), p<0.001. There was a statistically significant increase in operative time with uteri >250g (174.4 min vs. 127.5 min, p<0.001). Furthermore, operative time was significantly correlated with increasing uterine weight (β = 122.5, SE: 0.0, 95% CI: 0.1 – 0.2), p<0.001). No differences were detected in rate of surgical complications (p<0.195), reoperation (p<0.275), length of stay (p<0.466), or readmission (p<0.553). Transfusion frequency over all types of hysterectomy was uncommon however was significantly different (7/9 uteri >250g [78%] vs. 2/9 uteri <250g [22%], p=.001). A greater percentage of patients with uteri >250g had a diagnosis of menorrhagia (32% vs. 20%, p<0.001), fibroids (38% vs. 4%, p<0.001) and had a lower pre-operative hemoglobin (12.7 vs.11.7, p<0.001). Results suggest that patients undergoing benign MIH with uteri >250g experience greater perioperative morbidity as indicated by increased operative time and transfusion rate. The lack of difference in surgical complications, reoperation, length of stay, or readmission suggests that morbidity may be limited to the additional operative time.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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• W4212828305 date "2022-03-01" @default.
• W4212828305 modified "2023-10-01" @default.
• W4212828305 title "Does perioperative morbidity increase in uteri >250 grams in minimally invasive hysterectomy?" @default.
• W4212828305 doi "https://doi.org/10.1016/j.ajog.2021.12.078" @default.
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