title: Factors associated with complications and conversion to laparotomy in women undergoing laparoscopically assisted vaginal hysterectomy.
abstract: OBJECTIVE
  To identify risk factors for complications and conversion to laparotomy in women undergoing laparoscopically assisted vaginal hysterectomy (LAVH).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary referral hospital.
  
  
  METHODS
  All 2012 consecutive women who underwent LAVH for non-malignant diseases in a single institution.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Operative complications and conversion to laparotomy.
  
  
  RESULTS
  Most of the LAVHs were successful, but conversion to laparotomy was required in 97 women (4.8%) because of pelvic adhesion (n= 71), large uterine size (n= 18) or bowel injury (n= 8). There were 45 women (2.2%) with complications (bladder injury, 26; bowel injury, 9; vascular injury, 9; and ureteral injury, 1). A history of previous cesarean section (twice or more) was a significant risk factor for complications [odds ratio (OR) 3.38]. A body mass index ≥30 kg/m(2) (OR 2.98), history of previous myomectomy (OR 6.19) and uterine weight ≥500 g (OR 3.24) independently influenced the risk of conversion to laparotomy.
  
  
  CONCLUSIONS
  Risk factors identified in this study include a history of previous cesarean section (twice or more) and myomectomy, body mass index ≥30 kg/m(2) and uterine weight ≥500 g. The findings may be useful in counseling women preoperatively about the potential complications of LAVH.
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
authors.forename: Taejong
authors.initials: T
authors.lastname: Song
authors.forename: Tae-Joong
authors.initials: TJ
authors.lastname: Kim
authors.forename: Heeseok
authors.initials: H
authors.lastname: Kang
authors.forename: Yoo-Young
authors.initials: YY
authors.lastname: Lee
authors.forename: Chel Hun
authors.initials: CH
authors.lastname: Choi
authors.forename: Jeong-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Byoung-Gie
authors.initials: BG
authors.lastname: Kim
authors.forename: Duk-Soo
authors.initials: DS
authors.lastname: Bae
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal; D007431:Intraoperative Complications / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014599:Uterus / Q000473:pathology