Literature DB >> 21603525

Postoperative readmissions following laparoscopic and abdominal hysterectomy: a comparison.

John P Judd, Kenneth Byrd, Mark Jiang.   

Abstract

OBJECTIVE: To quantify the readmission rates for total laparoscopic and total abdominal hysterectomy, as well as identify preoperative, intraoperative, and postoperative risk factors for readmission within 6 weeks of surgery.
METHODS: A retrospective comparative study was performed using a departmental database to identify all readmissions following total laparoscopic and total abdominal hysterectomy and to assemble a control group. For each patient, the following data were systematically collected: surgery date, age, parity, body mass index, indications for surgery, type of procedure performed, uterine size, number of prior cesarean sections, number of prior laparoscopic abdominal surgeries, number of prior open abdominal surgeries, presence of adhesions at time of hysterectomy, diabetic status, operative time, postoperative hematocrit, intraoperative and postoperative complications, surgeon, use of postoperative antibiotics, postoperative day readmitted, reason for readmission, length of readmission, and whether the patient returned to the operating room during the readmission.
RESULTS: From January 1, 2000 to April 1, 2007, 1,576 total abdominal and 1,198 total laparoscopic hysterectomies were performed at Ochsner Medical Center. Of these, 19 abdominal and 31 laparoscopic hysterectomy patients were readmitted within 6 weeks of surgery. Our control groups consisted of 84 laparoscopic and 53 abdominal hysterectomy patients. A statistically significant difference in readmission rates (1.2% following abdominal hysterectomy vs. 2.7% following laparoscopic hysterectomy) was identified. No correlation between readmission and operative time, adhesive disease, diabetic status, prior cesarean sections, prior open or laparoscopic procedures, postoperative antibiotic use or postoperative hematocrit could be identified. Compared to those undergoing abdominal hysterectomy, those undergoing laparoscopic hysterectomy had more readmissions due to cuff dehiscence and cuff cellulitis for (p  =  0.0146), which is a previously recognized complication of total laparoscopic hysterectomy. We were unable to identify any significant difference in postoperative day of readmission, length of readmission, or return to operating room.
CONCLUSION: Further investigation would benefit from an expanded study group, which may result in identification of some significance of the studied factors that were not able to be identified in this study.

Entities:  

Keywords:  Abdominal hysterectomy; laparoscopic hysterectomy

Year:  2007        PMID: 21603525      PMCID: PMC3096398     

Source DB:  PubMed          Journal:  Ochsner J        ISSN: 1524-5012


  8 in total

Review 1.  Total laparoscopic hysterectomy and laparoscopic supracervical hysterectomy.

Authors:  William H Parker
Journal:  Obstet Gynecol Clin North Am       Date:  2004-09       Impact factor: 2.844

2.  Hysterectomy: evolution and trends.

Authors:  Thomas F Baskett
Journal:  Best Pract Res Clin Obstet Gynaecol       Date:  2004-12-30       Impact factor: 5.237

3.  Laparoscopic hysterectomy versus total abdominal hysterectomy: a comparative study.

Authors:  Edi Vaisbuch; Chen Goldchmit; Dganit Ofer; Arnon Agmon; Zion Hagay
Journal:  Eur J Obstet Gynecol Reprod Biol       Date:  2006-04-17       Impact factor: 2.435

Review 4.  Complications and recovery from laparoscopy-assisted vaginal hysterectomy compared with abdominal and vaginal hysterectomy.

Authors:  S F Meikle; E W Nugent; M Orleans
Journal:  Obstet Gynecol       Date:  1997-02       Impact factor: 7.661

5.  Laparoscopic hysterectomy: the Kaiser Permanente San Diego experience.

Authors:  Clement P Hoffman; John Kennedy; Laura Borschel; Raoul Burchette; Alexandra Kidd
Journal:  J Minim Invasive Gynecol       Date:  2005 Jan-Feb       Impact factor: 4.137

6.  A comparison of laparoscopic supracervical hysterectomy and total abdominal hysterectomy outcomes.

Authors:  O Robert Sarmini; Kimberly Lefholz; Harry P Froeschke
Journal:  J Minim Invasive Gynecol       Date:  2005 Mar-Apr       Impact factor: 4.137

7.  Total laparoscopic hysterectomy: preoperative risk factors for conversion to laparotomy.

Authors:  Franck Leonard; Nicolas Chopin; Bruno Borghese; Adolphe Fotso; Hervé Foulot; Joël Coste; Alexandre Mignon; Charles Chapron
Journal:  J Minim Invasive Gynecol       Date:  2005 Jul-Aug       Impact factor: 4.137

8.  Short- and long-term clinical results of laparoscopic-assisted vaginal hysterectomy and total abdominal hysterectomy.

Authors:  Chung-Chang Shen; Ming-Ping Wu; Cheng-Hsien Lu; Eng-Yen Huang; Hsieh-Wen Chang; Fu-Jen Huang; Te-Yao Hsu; Shiuh-Young Chang
Journal:  J Am Assoc Gynecol Laparosc       Date:  2003-02
  8 in total

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