title: Incidence of complications in patients with benign gynecological diseases by BMI and level of complexity of laparoscopic surgery.
abstract: BACKGROUND
  Laparoscopic surgery has become a standard surgical method for benign gynecological diseases, but the technique can still be accompanied, albeit infrequently, by intraoperative or postoperative complications. It has been postulated that the frequency of complications differs according to patient body habitus or surgical challenge level. We evaluated the relationship between the complication rate at different levels of surgery and BMI in patients with benign gynecological diseases who have undergone laparoscopic surgery at our hospital.
  
  
  METHODS
  A total of 3231 patients who underwent laparoscopic surgery between 1989 and 2010 were enrolled in this study retrospectively. They were classified into four groups by surgery level (diagnostic laparoscopy or minor, major, or advanced laparoscopic surgery). At each challenge level, patients were classified into three groups based on BMI (as defined by the WHO): A group (underweight), BMI < 18.5; B group (healthy), BMI ≥ 18.5 and < 25; and C group (overweight), BMI ≥ 25. We compared the complication rates between the groups at each level of surgical challenge.
  
  
  RESULTS
  There was no difference in the complication rate between groups A, B and C at any of the surgical challenge levels. However, at the higher surgical difficulty levels, a higher incidence of overall complications was observed.
  
  
  CONCLUSIONS
  The complication rate differs between surgical levels, and complications can occur in any type of surgery, irrespective of the body habitus of the patient. The complication rate is higher when difficult surgical methods are employed, and extra caution is needed.
authors: Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osaka, Japan. shiota@med.kindai.ac.jp
authors: M
authors: M
authors: Shiota
authors: Y
authors: Y
authors: Kotani
authors: M
authors: M
authors: Umemoto
authors: T
authors: T
authors: Tobiume
authors: H
authors: H
authors: Hoshiai
mesh_terms: D015992:Body Mass Index; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology*; D010535:Laparoscopy / Q000379:methods*; D050177:Overweight / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome