The Clinical Analysis Of 244 Cases Different Body Mass Index Women With Total Laparoscopic Hysterectomy

Objective:This retrospective review of patients underwent total laparoscopic hysterectomy examines whether differences in outcomes exist on the basis of body mass index (BMI).Methods: All cases of total laparoscopic hysterectomy performed from May 2005 to May 2007 for benign diagnoses, and microinvasive cervical cancer, early endometrial carcinoma were reviewed. All cases were analyzed by BMI category Results: There were 244 patients analyzed by BMI category (range, 17–38.2): ideal (n =128) less than 23.9 kg/m~2, overweight (n = 66) 24.0 to 27.9 kg/m~2, and obese (n =50)28 kg/m~2 or more.The statistically significant difference was found only in mean operating time (mean operating time were 81.3±25.5minutes,89.5±27.8minutes and 90.7±26.0minutes respectively,P< 0.05).And,the needing of operating time of dieal group was shorter than overweight and obese groups(p<0.05).However,there were no difference in operating time between overweight and obese group(p>0.05).Blood loss (41.8±21.3ml,47.4±22.7ml and 47.0±32.8ml respectively), changes of hemoglobin content(-6.8±8.4g/L,-6.4±8.2g/L and -4.4±7.7g/L respectively), anus exhaust time(1.8±0.7d,1.9±0.7days and 1.9±0.7days respectively) and length of hospital stay (8.3±1.7days,8.4±1.3 days and 8.6±1.7 days respectively) did not vary by BMI group(p>0.05).In addition,the average temperature were 37.0±0.3 oc,37.0±0.4 oc and 36.9±0.3 oc during first day postoperatively,and the average temperature of second and third day were 36.8±0.3 oc,36.9±0.3 oc,36.8±0.3 oc and 36.7±0.2 oc,36.7±0.3 oc,36.7±0.2 oc respectively.there were also not vary in each group(p>0.05).Total complication rates were 2%, and major (0.8%) and minor (1.2%) complication rates were similar in each BMI group. ureteral injury , transfusion postoperatively and so on were not observed in each BMI group.Conclusion: Total laparoscopic hysterectomy is feasible and safe, resulting in short hospital stay, minimal blood loss, and minimal operating time for patients in all BMI groups. The laparoscopic approach may extend the benefits of minimally invasive hysterectomy to the very obese, for whom abdominal surgery poses serious risk.