Abstract
Objective: The goal of this study was to test the hypothesis that a history of previous cesarean delivery does not increase the risk of conversion to laparotomy in patients undergoing laparoscopic supracervical hysterectomy (LSH) for benign gynecologic indications. Design: This was a retrospective cohort study. Materials and Methods: A retrospective cohort study was conducted of 799 patients who underwent LSH for benign gynecologic indications between January 2003 and December 2009. Results: There were a total of 16 (2%) conversions. The patients who underwent conversion were 5 times more likely to have a uterus that weighed ≥250 g (odds ratio [OR]: 5.2; 95% confidence interval [CI]: 1.8-17.4) and 3 times more likely to have had previous cesarean delivery (OR: 3.0; 95% CI: 1.1-8.0). These patients were also significantly more likely to need concomitant adhesiolysis in addition to the primary procedure (OR: 3.5; 95% CI: 1.2-9.8). However, after controlling for confounders (body mass index, blood loss, concomitant adhesiolysis, previous cesarean delivery, and uterine weight) only the presence of previous cesarean delivery ≥3 cesearean deliveries (adjusted odds ratio [AOR]: 6.41; 95% CI: 1.24-33.48; p=0.03) and uterine weight ≥250 g (AOR: 6.51; 95% CI: 1.74-24.38; p=0.005) were associated with conversion to laparotomy. Conclusions: The rate of conversion to laparotomy during LSH increases with history of ≥3 previous cesarean deliveries and uterine weight ≥250 g. (J GYNECOL SURG 29:275)
| Original language | English (US) |
|---|---|
| Pages (from-to) | 275-280 |
| Number of pages | 6 |
| Journal | Journal of Gynecologic Surgery |
| Volume | 29 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 1 2013 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Obstetrics and Gynecology
- Surgery
Cite this
Prior cesarean delivery and risk of conversion to laparotomy during laparoscopic hysterectomy. / Hobson, Deslyn T G; Imudia, Anthony N.; Al-Safi, Zain A.; Shade, George; Diamond, Michael Peter; Awonuga, Awoniyi O.
In: Journal of Gynecologic Surgery, Vol. 29, No. 6, 01.12.2013, p. 275-280.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prior cesarean delivery and risk of conversion to laparotomy during laparoscopic hysterectomy
AU - Hobson, Deslyn T G
AU - Imudia, Anthony N.
AU - Al-Safi, Zain A.
AU - Shade, George
AU - Diamond, Michael Peter
AU - Awonuga, Awoniyi O.
PY - 2013/12/1
Y1 - 2013/12/1
N2 - Objective: The goal of this study was to test the hypothesis that a history of previous cesarean delivery does not increase the risk of conversion to laparotomy in patients undergoing laparoscopic supracervical hysterectomy (LSH) for benign gynecologic indications. Design: This was a retrospective cohort study. Materials and Methods: A retrospective cohort study was conducted of 799 patients who underwent LSH for benign gynecologic indications between January 2003 and December 2009. Results: There were a total of 16 (2%) conversions. The patients who underwent conversion were 5 times more likely to have a uterus that weighed ≥250 g (odds ratio [OR]: 5.2; 95% confidence interval [CI]: 1.8-17.4) and 3 times more likely to have had previous cesarean delivery (OR: 3.0; 95% CI: 1.1-8.0). These patients were also significantly more likely to need concomitant adhesiolysis in addition to the primary procedure (OR: 3.5; 95% CI: 1.2-9.8). However, after controlling for confounders (body mass index, blood loss, concomitant adhesiolysis, previous cesarean delivery, and uterine weight) only the presence of previous cesarean delivery ≥3 cesearean deliveries (adjusted odds ratio [AOR]: 6.41; 95% CI: 1.24-33.48; p=0.03) and uterine weight ≥250 g (AOR: 6.51; 95% CI: 1.74-24.38; p=0.005) were associated with conversion to laparotomy. Conclusions: The rate of conversion to laparotomy during LSH increases with history of ≥3 previous cesarean deliveries and uterine weight ≥250 g. (J GYNECOL SURG 29:275)
AB - Objective: The goal of this study was to test the hypothesis that a history of previous cesarean delivery does not increase the risk of conversion to laparotomy in patients undergoing laparoscopic supracervical hysterectomy (LSH) for benign gynecologic indications. Design: This was a retrospective cohort study. Materials and Methods: A retrospective cohort study was conducted of 799 patients who underwent LSH for benign gynecologic indications between January 2003 and December 2009. Results: There were a total of 16 (2%) conversions. The patients who underwent conversion were 5 times more likely to have a uterus that weighed ≥250 g (odds ratio [OR]: 5.2; 95% confidence interval [CI]: 1.8-17.4) and 3 times more likely to have had previous cesarean delivery (OR: 3.0; 95% CI: 1.1-8.0). These patients were also significantly more likely to need concomitant adhesiolysis in addition to the primary procedure (OR: 3.5; 95% CI: 1.2-9.8). However, after controlling for confounders (body mass index, blood loss, concomitant adhesiolysis, previous cesarean delivery, and uterine weight) only the presence of previous cesarean delivery ≥3 cesearean deliveries (adjusted odds ratio [AOR]: 6.41; 95% CI: 1.24-33.48; p=0.03) and uterine weight ≥250 g (AOR: 6.51; 95% CI: 1.74-24.38; p=0.005) were associated with conversion to laparotomy. Conclusions: The rate of conversion to laparotomy during LSH increases with history of ≥3 previous cesarean deliveries and uterine weight ≥250 g. (J GYNECOL SURG 29:275)
UR - http://www.scopus.com/inward/record.url?scp=84890533521&partnerID=8YFLogxK
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U2 - 10.1089/gyn.2013.0018
DO - 10.1089/gyn.2013.0018
M3 - Article
VL - 29
SP - 275
EP - 280
JO - Journal of Gynecologic Surgery
JF - Journal of Gynecologic Surgery
SN - 1042-4067
IS - 6
ER -