Kantarcı Sercan, Karabulut Alaattin, Dağlı Uğurcan, Yetimoğlu Elif, İleri Alper, Hamdi İnan Abdurrahman
Department of Obstetrics and Gynecology, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey.
JSLS. 2025 Jul-Sep;29(3). doi: 10.4293/JSLS.2025.00066. Epub 2025 Sep 3.
This study evaluates emergency department (ED) visits within the first 30 days following hysterectomy for benign gynecologic conditions, identifying risk factors and strategies for prevention.
A retrospective cohort analysis was conducted on 2,119 patients who underwent hysterectomy at a high-volume tertiary center between January 2023 and December 2024. Demographic, perioperative, and postoperative variables were analyzed, and predictors of ED visits were assessed using multivariable logistic regression.
ED visits occurred in 8.6% of patients, with older age, higher intraoperative blood loss, longer operative time, and prior abdominal surgery being significant predictors ( < .05). Vaginal cuff hematoma (29.7%) was the most common cause of hospitalization, whereas abdominal pain (39.3%) and nausea/vomiting (40.7%) were the most frequent nonhospitalized complaints. Minimally invasive techniques were associated with lower ED visit rates compared to total abdominal hysterectomy.
Identifying high-risk patients and implementing structured postoperative monitoring may reduce unnecessary ED visits. Optimizing surgical techniques, perioperative management, and patient education is crucial for enhancing outcomes and reducing healthcare burden. Multicenter prospective studies are needed to validate these findings and refine perioperative strategies.
本研究评估因良性妇科疾病行子宫切除术后30天内的急诊科就诊情况，确定危险因素及预防策略。
对2023年1月至2024年12月在一家大型三级中心接受子宫切除术的2119例患者进行回顾性队列分析。分析人口统计学、围手术期和术后变量，并使用多变量逻辑回归评估急诊科就诊的预测因素。
8.6%的患者出现急诊科就诊，年龄较大、术中失血量较多、手术时间较长以及既往腹部手术是显著的预测因素（<0.05）。阴道残端血肿（29.7%）是住院最常见的原因，而腹痛（39.3%）和恶心/呕吐（40.7%）是最常见的非住院主诉。与全腹子宫切除术相比，微创技术与较低的急诊科就诊率相关。
识别高危患者并实施结构化的术后监测可减少不必要的急诊科就诊。优化手术技术、围手术期管理和患者教育对于改善结局和减轻医疗负担至关重要。需要多中心前瞻性研究来验证这些发现并完善围手术期策略。
