Laparoscopic-assisted vaginal hysterectomy in women of all weights and the effects of weight on complications.
OBJECTIVE
To compare intraoperative and postoperative complication rates for laparoscopic-assisted vaginal hysterectomy (LAVH) between women classified as obese, normal weight, or very thin based on body mass index (BMI).


METHODS
Retrospective cohort study (Canadian Task Force classification II-3).


METHODS
University hospital.


METHODS
Six hundred seventy women (162 with BMI >25, 34 with BMI <18.5, 474 with BMI 18.5-25 kg/m(2)).


METHODS
LAVH.


RESULTS
For women with high BMIs, 34 procedures (21.0%) were converted to laparotomy, compared with 48 (10.1%) for women of normal body weight and 3 (8.8%) for those with low BMI (p = 0.001). Average blood loss was 299.3 +/- 87.8, 219.1 +/- 57.5, and 231.8 +/- 65.9 ml, respectively (p <0.001). Very thin women had similar intraoperative and postoperative complication rates (8.8 %) as women of normal body weight (8.6%) and obese women (11.1%).


CONCLUSIONS
Obese women had increased likelihood of conversion to laparotomy and greater blood loss after LAVH than nonobese women. Very thin women had similar intraoperative and postoperative complication rates as women of normal body weight and obese women.
Shen
Chung-Chang
CC
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, 4F-4, 123-6, Ta-Pei Road, Niao Sung Hsiang, Kaohsiung, Taiwan.
Hsu
Te-Yao
TY
Huang
Fu-Jen
FJ
Huang
Eng-Yen
EY
Huang
Hsuan-Wei
HW
Chang
Hung-Yao
HY
Chang
Chih-Yang
CY
Weng
Hsu-Huei
HH
Chang
Hsueh-Wen
HW
Chang
Shiuh-Young
SY
D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000473:pathology / Q000601:surgery*