McIlwaine Kate, Manwaring Janine, Ellett Lenore, Cameron Melissa, Readman Emma, Villegas Rocio, Maher Peter
Department of Endosurgery, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2014 Dec;54(6):564-9. doi: 10.1111/ajo.12258.
Over the past three decades, rates of overweight and obesity internationally have risen to epidemic proportions. There are currently no published prospective studies examining the effect of obesity on gynaecologic laparoscopy for benign indications within a population with obesity rates comparable to Australian women.
To assess and quantify whether increasing patient body mass index negatively impacted upon the ability to successfully complete planned laparoscopic surgery.
From January 2009 until October 2012, 307 women undergoing laparoscopic gynaecological surgery for benign pathology were recruited. Intra-operative variables included the following: ease of identification of anatomical landmarks, entry technique and number of attempts, conversion to laparotomy and any complications encountered. Any post-operative complications were recorded at the six week post-operative review.
94.46% of operations were completed as planned. As BMI increased, the ease of identification of important anatomical landmarks significantly decreased. There was no correlation between increasing BMI and surgical complication rates.
Planned gynaecological laparoscopy can be performed in obese patients with a high likelihood of completion. In this study, obesity was not associated with a significant increase in complication rates or failure to complete the surgery as planned.
在过去三十年里，国际上超重和肥胖率已上升至流行程度。目前尚无已发表的前瞻性研究，在肥胖率与澳大利亚女性相当的人群中，探讨肥胖对良性指征妇科腹腔镜手术的影响。
评估并量化患者体重指数的增加是否会对成功完成计划腹腔镜手术的能力产生负面影响。
从2009年1月至2012年10月，招募了307名因良性病变接受腹腔镜妇科手术的女性。术中变量包括：解剖标志的识别难易程度、进入技术和尝试次数、转为开腹手术以及遇到的任何并发症。在术后六周复查时记录任何术后并发症。
94.46%的手术按计划完成。随着体重指数增加，重要解剖标志的识别难易程度显著降低。体重指数增加与手术并发症发生率之间无相关性。
计划的妇科腹腔镜手术在肥胖患者中很有可能完成。在本研究中，肥胖与并发症发生率显著增加或未能按计划完成手术无关。
