Evaluation of the surgical outcome and complications of total laparoscopic hysterectomy in patients with enlarged uteruses

Abstract

Objective: The aim of this study was to investigate whether uterine weight has a deleterious effect on the operation time, complication rates, length of hospital stay and incidence of intraoperative haemorrhage during total laparoscopic hysterectomy operation. Methods: A total of 282 patients who underwent total laparoscopic hysterectomy for benign gynaecologic indications were retrospectively analyzed. The median operation time of 70 min was accepted as an index number, and a cut-off point of >= 300 g was calculated for uterine weight by using reciever operator characteristics (ROC) curve analysis. Results: There was no statistically significant relationship between the uterine weight and haemoglobin drop rate (1.27 +/- 0.89 vs 1.21 +/- 0.88, p = 0.905), complication rate (10.83\% vs 9.26\%, p = 0.062) and length of hospital stay (3.27 +/- 1.23 vs 3.37 +/- 1.35 days, p = 0.505) based on this cut. Lee-Huang point was preferred for abdominal entry in cases with uteruses reached the level of umbilicus -2 cm in physical examination. Conclusions: Uterine weight was not effected the complication rate, estimated blood loss and length of hospital stay in total laparoscopic hysterectomy operation. A cut-off value of 300 g could be used for an increased operation time. (C) 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.