Effect of body mass index on clinical outcomes of patients undergoing total laparoscopic hysterectomy

• Published in: International journal of gynecology and obstetrics Vol. 120; no. 1; pp. 61 - 64
• Main Authors: Morgan-Ortiz, Fred, Soto-Pineda, Juan M, López-Zepeda, Marco A, Peraza-Garay, Felipe de Jesús
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.01.2013; Elsevier
• Subjects: Adult; Biological and medical sciences; Blood Loss, Surgical - statistics & numerical data; Body Mass Index; Digestive system. Abdomen; Endoscopy; Female; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy - methods; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy - methods; Laparotomy - methods; Length of Stay; Medical sciences; Mexico; Obesity; Obesity - complications; Obstetrics and Gynecology; Operative morbidity; Operative Time; Overweight; Overweight - complications; Pain, Postoperative - epidemiology; Postoperative Complications - epidemiology; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Total laparoscopic hysterectomy; Treatment Outcome; Mexico; Body mass index; Obesity; Operative morbidity; Total laparoscopic hysterectomy; Overweight; Human; Prognosis; Gynecology; Nutrition disorder; Laparoscopy; Hysterectomy; Obstetrics; Morbidity; Treatment; Surgery; Endoscopy; Nutritional status
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2012.08.012

Abstract Objective To evaluate the effect of normal body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) and obesity on clinical results among patients who underwent total laparoscopic hysterectomy (TLH). Methods In a prospective study at the Civil Hospital of Culiacan in Sinaloa State, Mexico, data were compared from 209 patients who underwent TLH between July 6, 2009, and December 30, 2011. The following primary variables were analyzed for 77 normal BMI patients, 82 overweight patients, and 50 obese patients: procedure duration, operative bleeding, major and minor trans-operative complications, length of hospital stay, and postoperative pain. Results The mean duration of surgical procedure ( P < 0.001) and operative bleeding ( P = 0.002) were lower for patients with normal BMI compared with the other 2 groups. The rate of conversion to laparotomy was similar among the 3 groups. Overall, the frequency of complications was 6.2% (n = 13/209); the frequency of complications by study group was 2.6%, 4.8%, and 14% for the normal BMI, overweight and obesity groups, respectively ( P < 0.05). Major complications were more frequent among patients with obesity ( P = 0.010). Conclusion The duration of surgical procedure and operative morbidity were found to increase, mainly owing to major complications, among patients with obesity (BMI ≥ 30).