Impact of clinicopathological variables on laparoscopic hysterectomy complications, a tertiary center experience

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Akgör U., Kuru O., Güneş A. C., Karataş E., Temiz B. E., Erzeneoğlu B. E., ...More

Ginekologia Polska, vol.1, no.2, pp.1-10, 2021 (SCI-Expanded)

  • Publication Type: Article / Article
  • Volume: 1 Issue: 2
  • Publication Date: 2021
  • Doi Number: 10.5603/gp.a2021.0097
  • Journal Name: Ginekologia Polska
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, Gender Studies Database, MEDLINE, Directory of Open Access Journals
  • Page Numbers: pp.1-10
  • Hacettepe University Affiliated: Yes


Objectives: To analyze intraoperative and postoperative complications according to Clavian-

Dindo Classification (CDC) and evaluate the influence of clinicopathological features on the

feasibility and safety of total laparoscopic hysterectomy (TLH) in patients that underwent

surgery in a tertiary center.

Material and methods: We retrospectively reviewed the database of 469 patients that

underwent surgery for patients who underwent extra facial TLH from 2013 to 2020.



Results: A total of 86 (18.3%) peri-postoperative complications were observed. The

incidence of intraoperative complications was 2% (n = 10). The overall conversion rate to

open surgery was 1.9% (n = 9). A total of 76 postoperative complications were observed in 61

patients (14.3%). The incidence of minor (Grade I [n = 16, 3.4%] and II [n = 42, 8.9%]) and

major complications (Grade III [n = 15, 3.2%], IV [n = 2, 0.4%] and V [n = 1, 0.2 %]) were 12.3% and 3.8%, respectively.

A higher BMI and performing surgery at the first step of learning are found to be associated

with intraoperative and postoperative complications (p < 0.05). Postoperative complications

related to having a history of the cesarean section, additional comorbidities, and uterine

weight ≥ 300 g (p < 0.05).

Conclusions: The implementation of TLH by experienced surgeons appears to have

remarkable advantages over open surgery. However, the risk factor for complications should

be taken into account by surgeons in the learning curve in selecting the appropriate patient for