Department of Gynecology and Obstetrics, Saarland University Hospital, Kirrbergerstraße 100, 66421, Homburg, Saar, Germany.
Department of Gynecology and Obstetrics, Klinikum Bremen-Nord, Bremen, Germany.
Arch Gynecol Obstet. 2021 Aug;304(2):447-454. doi: 10.1007/s00404-021-06064-0. Epub 2021 May 3.
Vaginal cuff dehiscence (VCD) is one of the major surgical complications following hysterectomy with data on incidence rates varying largely and studies assessing risk factors being sparse with contradictive results. The aim of this study was to assess the incidence rate of and risk factors for VCD in a homogenous cohort of women treated for benign uterine pathologies via total laparoscopic hysterectomy (TLH) with standardized follow-up.
All patients undergoing TLH at the Department of Gynecology and Obstetrics, Saarland University Hospital between November 2010 and February 2019 were retrospectively identified from a prospectively maintained service database.
VCD occurred in 18 (2.9%) of 617 patients included. In univariate and multivariate analyses, a lower level of surgeon laparoscopic expertise (odds ratio 3.19, 95% confidence interval (CI) 1.0-9.38; p = 0.03) and lower weight of removed uterus (odds ratio 0.99, 95% CI 0.98-0.99; p = 0.02) were associated positively with the risk of VCD.
In this homogenous cohort undergoing TLH, laparoscopic expertise and uterine weight influenced the risk of postoperative VCD. These findings might help to further reduce the rate of this complication.
阴道残端破裂（VCD）是子宫切除术后的主要手术并发症之一，其发生率数据差异很大，且评估风险因素的研究很少，结果存在矛盾。本研究旨在评估通过标准化随访行全腹腔镜子宫切除术（TLH）治疗良性子宫病变的同质队列中 VCD 的发生率和风险因素。
回顾性地从萨尔兰大学医院妇产科 2010 年 11 月至 2019 年 2 月期间行 TLH 的患者前瞻性维护的服务数据库中确定所有患者。
617 例患者中有 18 例（2.9%）发生 VCD。在单因素和多因素分析中，手术医生腹腔镜手术经验水平较低（比值比 3.19，95%置信区间（CI）1.0-9.38；p=0.03）和切除子宫的重量较低（比值比 0.99，95%CI 0.98-0.99；p=0.02）与 VCD 的风险呈正相关。
在本同质队列中，腹腔镜手术经验和子宫重量影响术后 VCD 的风险。这些发现可能有助于进一步降低该并发症的发生率。
