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2018, Number 3

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Revista Cubana de Cirugía 2018; 57 (3)

Risk factors under lengthened surgical time in laparoscopic hysterectomy

Fernández GA, Ramos PA, Rosales AY, López AY, Pujol LP

Language: Spanish
References: 31
Page: 1-10
PDF size: 142.87 Kb.


ABSTRACT

Introduction: Hysterectomies are one of the surgical procedures most performed worldwide. Among the advantages of laparoscopic hysterectomy, we can mention less intraoperative bleeding, shorter hospital stay, faster recovery, and decreased infection rate in the surgical site. However, all this is achieved at the expense of a longer surgical time, higher cost, and increase in ureteral and bladder injuries.
Objective: To identify the risk factors that influence the lengthening of surgical time in patients undergoing a laparoscopic hysterectomy.
Method: An analytical, observational case-control study. We evaluated the patients performed video-assisted laparoscopic hysterectomy from January 2012 to December 2016 at Carlos Manuel de Céspedes University Hospital in Bayamo, Granma (Cuba). These patients made up the study population. The sample consisted of the cases, made up by all patients with lengthened surgical time (130 minutes or more), and the controls, those patients with surgical time less than 130 minutes. A probabilistic sampling was carried out with approximate matching for each variable.
Results: In the univariate analysis, the risk factors were the delay for this type of intervention, the antecedents of previous caesarean sections (p=0.001), uterus weighing more than 320 grams (p=0.001), mobility to vaginal touch (p=0.013), difficulty in uterine descent to vaginal touch (p=0.003), and the execution of another intervention during hysterectomy (p=0.003). In the multivariate analysis, we identified the uterus weighing more than 320 g (p=0.012), performing another procedure during the procedure (p=0.021), and previous caesarean section (p=0.043) as the main risk factors.
Conclusions: The factors that influenced the lengthening of the hysterectomy most were antecedents of cesarean section, uterus with an estimated weight greater than 320 g, and the execution of other interventions during the same procedure.


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