Analysis On Postoperative Morbidity And Complications In402Cases Of Simplex Total Laparoscopic Hysterectomy

Objective: To assess the influential factors for the postoperative morbidity andcomplications of Total Laparoscopic Hysterectomy (TLH).Methods: the clinical data of402cases of patients with TLH who were admitted inDalian Maternity Hospital from December2012to December2013were summarizedretrospectively. The χ2test was used to analyze the statistical difference of postoperativemorbidity between the patients with conization and without conization, the patients withand without vaginitis and the patients passed different time since they got conization.Univariate logistic regression analysis were used to analyze the relationship between thecomplications of TLH and the parameters of patients, for instance, age, BMI, uterinesize, abdominal surgery history and endometriosis history.Results: All the cases were operated under laparoscopy. The mean operation timewas89.51±24.55min, the alteration of the hemoglobin concentration before and afteroperation was-6.88±5.81g/L, The mean highest body temperature of postoperativewas37.5±0.4℃,the postoperative hospital stay was5.2±2.1d, the postoperativemorbidity rate was5.72%, the complications rate was3.98%. The results of χ2testshowed that the difference between the patients with conization and without conization,between the patients with and without vaginitis was statistically significant,(χ2=19.535P=0.000and χ2=10.416, P=0.001respectively), however, the difference betweenpatients passed different time since they got conization was not statistically significant,(χ2=2.463, P=0.117). The complications during insertion of the verres needle and establishment of pneumoperitoneum were note in2cases (0.49%): full of abdominalvessel damage. Intra-operative complications occurred in4patients (0.99%):2cases ofexcessive blood loss,1case of ureteral injury,1case of bowel injury. Post-operativecomplications occurred in10patients (2.4%), this figure represented62.5%of allcomplications:2cases of intestinal obstruction,1case of abdominal cavity hemorrhage,4cases of vagina stump hemorrhage,3cases of pelvic abscess. Univariate logisticanalysis showed that age, BMI, uterine size, abdominal surgery history with TLHcomplications unrelated, endometriosis history (OR=6.564) was the major risk factorof complications in TLH.Conclusions:1. From December2012to December2013, about the cases with TLH, theincidences of postoperative morbidity and complication was5.72%and3.98%respectively. The postoperative complication was dominated.2. The postoperative morbidity of patients with conization was significantly higherthan the patients without conization.3. The difference between the patients passed different time since they gotconization was not statistically significant, it could not be consider that there isdifference between these two groups.4. The postoperative morbidity of patients with vaginitis was significantly higherthan the patients without vaginitis.5. The incidences of complication after TLH was irrelevant with age, BMI, uterinesize and abdominal surgery history.6. The endometriosis history is related to the complications of TLH, and it is therisk factors for the complications of TLH.