Peker Nurullah, Aydın Edip, Yavuz Mustafa, Bademkıran Muhammet Hanifi, Ege Serhat, Karaçor Talip, Ağaçayak Elif
Department of Obstetrics and Gynecology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey.
Department of Obstetrics and Gynecology, Health Sciences University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Ginekol Pol. 2019;90(12):692-698. doi: 10.5603/GP.2019.0118.
The study aimed to examine the predisposing factors that play a role in the development of complications in patients undergoing vaginal hysterectomy.
This retrospective analysis was performed on data provided from 239 patients who underwent vaginal hysterectomy due to uterine prolapse at a single centre between January 2008 and August 2018. Complications were defined according to Clavien-Dindo classification of complications. The patients were divided into two groups: with and without complications. We built a model using multivariable logistic regression to examine the relationships between complications and five candidate predictors.
Intra/postoperative complications developed in 30 patients, and the complication rate was found to be 12.5%. 87.2% of the reported complications were classified as Grade ≤ 2 according to Clavien-Dindo system. It was found that complications were associated with factors such as intraoperative concurrent salpingo-oophorectomy [Odds ratio (OR): 1.24 (1.1-1.4)], low preoperative haemoglobin [OR: 0.96 (0.94-0.98)], uterine weight [OR: 2.69 (2.62-2.76)], and long operation time [OR: 1.04 (1.02-1.07)]. History of pelvic surgery was not found to increase complication rate [OR: 1.11 (0.96-1.27), p = 0.13]. Our multiple logistic regression model correctly classified 74% of participants within the Receiver Operating Characteristic (ROC) curve.
Preoperative anaemia, large uterus and concomitant adnexectomy were found to be factors associated with complications during and after vaginal hysterectomy for pelvic organ prolapse.
本研究旨在探讨在接受阴道子宫切除术的患者中,导致并发症发生的诱发因素。
对2008年1月至2018年8月期间在单中心因子宫脱垂接受阴道子宫切除术的239例患者提供的数据进行回顾性分析。并发症根据Clavien-Dindo并发症分类进行定义。患者分为两组:有并发症组和无并发症组。我们使用多变量逻辑回归建立模型,以检验并发症与五个候选预测因素之间的关系。
30例患者发生术中/术后并发症,并发症发生率为12.5%。根据Clavien-Dindo系统,87.2%的报告并发症被分类为≤2级。研究发现,并发症与术中同时行输卵管卵巢切除术[比值比(OR):1.24(1.1 - 1.4)]、术前血红蛋白水平低[OR:0.96(0.94 - 0.98)]、子宫重量[OR:2.69(2.62 - 2.76)]以及手术时间长[OR:1.04(1.02 - 1.07)]等因素相关。未发现盆腔手术史会增加并发症发生率[OR:1.11(0.96 - 1.27),p = 0.13]。我们的多变量逻辑回归模型在受试者工作特征(ROC)曲线内正确分类了74%的参与者。
术前贫血、子宫大以及同时进行附件切除术被发现是盆腔器官脱垂患者阴道子宫切除术期间及术后并发症的相关因素。