Complications and results of 361 hysterectomies performed at laparoscopy.
BACKGROUND
Before the appropriate use of laparoscopy in hysterectomy can be determined, it is necessary to evaluate the results, including complications. There must also be an accepted classification system to facilitate accurate comparison to total abdominal hysterectomy.


METHODS
We retrospectively evaluated the charts of 361 women who underwent hysterectomy for various benign pathologic conditions. Intraoperative and postoperative complication rates for hysterectomy performed at operative laparoscopy were examined. The hysterectomies were classified as one of four types according to the number of steps performed laparoscopically. All women were candidates for total abdominal hysterectomy, but not vaginal hysterectomy.


RESULTS
The overall complication rate for hysterectomy performed at operative laparoscopy was 11.1 percent. Most complications were minor, including cystitis (1.66 percent), transient high fever (1.39 percent), abdominal wall ecchymosis (1.12 percent), and pneumonia and bronchitis (1.12 percent). There was no correlation between the type of laparoscopic hysterectomy performed and the complication rate.


CONCLUSIONS
Our rate of intraoperative and postoperative complications associated with laparoscopic hysterectomy compares favorably with published complication rates for vaginal and abdominal hysterectomy.
Nezhat
F
F
Department of Obstetrics and Gynecology, Mercer University School of Medicine, Macon, Georgia.
Nezhat
C H
CH
Admon
D
D
Gordon
S
S
Nezhat
C
C
D000009:Abdominal Muscles / Q000473:pathology; D000328:Adult; D000368:Aged; D001956:Broad Ligament / Q000601:surgery; D001991:Bronchitis / Q000209:etiology; D003556:Cystitis / Q000209:etiology; D004438:Ecchymosis / Q000209:etiology; D004598:Electrosurgery; D005260:Female; D005334:Fever / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000145:classification / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects* / Q000145:classification / Q000379:methods; D008022:Ligaments / Q000601:surgery; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology; D012189:Retrospective Studies; D012404:Round Ligament of Uterus / Q000601:surgery; D016896:Treatment Outcome; D014599:Uterus / Q000098:blood supply / Q000601:surgery; D014621:Vagina / Q000601:surgery