Department of Obstetrics and Gynecology, Saarland University Hospital, Kirrberger Str. 100, 66421, Homburg, Germany.
Arch Gynecol Obstet. 2014 Apr;289(4):803-7. doi: 10.1007/s00404-013-3050-2. Epub 2013 Oct 11.
To investigate the influence of the body mass index (BMI) on laparoscopic hysterectomy, including all intra- and postoperative findings and complications.
We reviewed and analyzed the medical records of 200 patients who underwent laparoscopic hysterectomy for benign disease at the Saarland University Hospital. The patient collective was subdivided into four weight groups on the basis of the current WHO BMI classification. Data analysis was carried out by a professional statistician.
Over half of the women screened were overweight or obese. The operating times increased together with the BMI (p = 0.017). Blood losses differed significantly between the weight groups (p = 0.027), but ranged to a maximum of only 300 ml. One laparoconversion had to be performed. No other intraoperative complications occurred. During our follow-up time of 13.2 ± 5.4 months, the overall rate of postoperative complications differed significantly between the weight groups (p = 0.008). The group of overweight women had the highest rate of complications and the group of obese women had the lowest. However, the rate of women who required readmission and reoperation was not elevated in the overweight group.
Laparoscopic hysterectomy is a safe and feasible method even in obese and morbidly obese patients. Overweight and obesity increase the time needed to perform laparoscopic hysterectomy but do not seem to relevantly influence the rate of major intra- or postoperative complications.
研究体质量指数（BMI）对腹腔镜子宫切除术的影响，包括所有围手术期发现和并发症。
我们回顾和分析了在萨尔兰大学医院因良性疾病接受腹腔镜子宫切除术的 200 名患者的病历。根据当前的世界卫生组织 BMI 分类，将患者分为四组体重组。数据分析由专业统计学家进行。
筛查出的女性中超过一半超重或肥胖。手术时间随 BMI 增加而增加（p=0.017）。出血量在各组之间差异显著（p=0.027），但最大仅为 300ml。有 1 例需要转为开腹手术。术中无其他并发症发生。在我们 13.2±5.4 个月的随访期间，各组术后并发症发生率差异显著（p=0.008）。超重组的并发症发生率最高，肥胖组最低。然而，超重组需要再次入院和再次手术的女性比例并没有增加。
即使在肥胖和病态肥胖患者中，腹腔镜子宫切除术也是一种安全可行的方法。超重和肥胖增加了腹腔镜子宫切除术所需的时间，但似乎并不显著影响主要围手术期并发症的发生率。
