Bhandari Shilpa, Agrawal Pallavi, Singh Aparna
Department of Obstetrics and Gynaecology, Sri Aurobindo Institute of Medical Sciences, Indore Ujjain Highway, Indore 453111, India.
Int Sch Res Notices. 2014 Oct 28;2014:787604. doi: 10.1155/2014/787604. eCollection 2014.
Objective. To evaluate operative and perioperative outcomes in patients undergoing total laparoscopic hysterectomy according to their body mass index. Method. A retrospective study was performed for patients undergoing total laparoscopic hysterectomy at a tertiary care center for a period of 4 years. Patients were divided into two groups: obese (BMI > 30 Kg/m(2)) and nonobese (BMI < 30 Kg/m(2)). Duration of surgery, intraoperative blood loss, successful laparoscopic completion, and intraoperative complications were compared in two groups. Result. A total of 253 patients underwent total laparoscopic hysterectomy from January 2010 to December 2013. Out of them, 105 women (41.5%) had a BMI of more than 30 kg/m(2). Overall, the mean blood loss was 85.79 ± 54.17 mL; the operative time was 54.17 ± 19.83 min. The surgery was completed laparoscopically in 244 (96.4%) women while laparotomy was done in 4 cases and vaginal suturing and closure of vault were done in 5 cases. Risk of vaginal assistance was higher in obese patients whereas out of the 4 conversions to laparotomy 3 had BMI < 30 kg/m(2). The operative time was increased as the BMI of patient increased. Conclusions. Total laparoscopic hysterectomy is a safe and effective procedure for obese patients and can be performed with an efficacy similar to that in nonobese patients.
目的。根据患者的体重指数评估接受全腹腔镜子宫切除术患者的手术及围手术期结局。方法。对一家三级医疗中心4年间接受全腹腔镜子宫切除术的患者进行回顾性研究。患者分为两组：肥胖组（BMI>30 Kg/m²）和非肥胖组（BMI<30 Kg/m²）。比较两组的手术时间、术中出血量、腹腔镜手术成功完成情况及术中并发症。结果。2010年1月至2013年12月共有253例患者接受全腹腔镜子宫切除术。其中，105名女性（41.5%）的BMI超过30 kg/m²。总体而言，平均失血量为85.79±54.17 mL；手术时间为54.17±19.83分钟。244名（96.4%）女性通过腹腔镜完成手术，4例进行了剖腹手术，5例进行了阴道缝合及穹窿关闭。肥胖患者阴道辅助的风险更高，而在4例转为剖腹手术的患者中，3例的BMI<30 kg/m²。手术时间随着患者BMI的增加而延长。结论。全腹腔镜子宫切除术对于肥胖患者是一种安全有效的手术，其疗效与非肥胖患者相似。
