title: Total laparoscopic hysterectomy in obese and morbidly obese women.
abstract: BACKGROUND
  The study aimed at estimating the effect of body mass index (BMI), used to classify non-obese, obese, and morbidly obese patients, on clinical outcomes in total laparoscopic hysterectomy (TLH) cases.
  
  
  METHODS
  This retrospective cohort study included 153 patients who underwent TLH for benign, premalignant, or malignant conditions between August 2010 and June 2013. Patients were divided into 3 groups according to BMI, and the following variables were analyzed: operation time, conversion rate, blood loss, total complications, and length of hospital stay.
  
  
  RESULTS
  The mean BMI was 33.5 kg/m(2) (range, 22-61). Forty-four patients were non-obese (BMI <30), 73 were obese (30≤ BMI <40), and 36 were morbidly obese (BMI ≥40). In 138 patients (90.2%), hysterectomy was performed using an endoscopic technique. The rate of conversion to laparotomy (9.8%; 95% confidence interval (CI), 5.1-14.5), blood loss (70.5 ml; range, 10-700), total complications (5.9%), and length of hospital stay (2.9 d; range, 1-8) did not vary according to BMI. Operation time was longer in obese (p = 0.003) and morbidly obese (0.002) patients than in non-obese patients.
  
  
  CONCLUSIONS
  TLH could be considered a safe and feasible alternative to abdominal hysterectomy in obese and morbidly obese patients.
authors: Departments of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, İstanbul, Turkey.
authors: Hakan
authors: H
authors: Guraslan
authors: Mehmet Baki
authors: MB
authors: Senturk
authors: Keziban
authors: K
authors: Dogan
authors: Birgul
authors: B
authors: Guraslan
authors: Bulent
authors: B
authors: Babaoglu
authors: Levent
authors: L
authors: Yasar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome