Association of Minimally Invasive Hysterectomy Route at the Time of Sacrocolpopexy with Postoperative Complications.

Abstract

Introduction and hypothesis: Minimally invasive sacrocolpopexy (SCP) with concomitant minimally invasive hysterectomy (MIH) is a frequently employed reconstructive surgical treatment for pelvic organ prolapse; however, the literature is limited regarding how the route of MIH affects postoperative adverse events. This study was aimed at investigating the association of route of MIH at the time of minimally invasive SCP and 30-day postoperative adverse events.

Methods: This was a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement database to compare perioperative adverse events for patients who underwent minimally invasive SCP with MIH for uterovaginal prolapse. MIH included total laparoscopic hysterectomy (TLH), laparoscopic supracervical hysterectomy (SCH), laparoscopy-assisted vaginal hysterectomy (LAVH) and total vaginal hysterectomy (TVH). Perioperative adverse events of the four routes of MIH were compared.

Results: During the study period, 7690 patients were identified. TLH was the most common route of MIH (56%), followed by laparoscopic SCH (39%), TVH (3%), and LAVH (2%). The rate of any 30-day adverse event was 10% and rates were similar between MIH groups. On multivariate logistic regression controlling for confounders, there were no significant differences in rates of postoperative adverse events between MIH groups.

Conclusion: Adverse events following MIH at the time of SCP are not associated with the route of hysterectomy.