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Does a prior hysterectomy complicate transvaginal/transumbilical hybrid NOTES cholecystectomy?—a comparative analysis of prospectively collected data

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Název: Does a prior hysterectomy complicate transvaginal/transumbilical hybrid NOTES cholecystectomy?—a comparative analysis of prospectively collected data
Autoři: Dirk R. Bulian, Axel Sauerwald, Panagiotis Thomaidis, Claudia S. Seefeldt, Dana C. Richards, Sissy-A. Schulz, Niklas J. Weltermann, Markus M. Heiss, Claus F. Eisenberger
Zdroj: Langenbecks Arch Surg
Informace o vydavateli: Springer Science and Business Media LLC, 2021.
Rok vydání: 2021
Témata: Natural Orifice Endoscopic Surgery, Hysterectomy, Female [MeSH], Outcome, Vagina/surgery [MeSH], Aged [MeSH], Colpotomy, Humans [MeSH], Hysterectomy/adverse effects [MeSH], Cholecystectomy/methods [MeSH], Retrospective Studies [MeSH], Natural Orifice Endoscopic Surgery/methods [MeSH], Cholecystectomy, Original Article, Transvaginal NOTES, Complication rate, Cholecystectomy/adverse effects [MeSH], Cholecystectomy, Laparoscopic/adverse effects [MeSH], Postoperative Complications/etiology [MeSH], Cholecystectomy, Laparoscopic/methods [MeSH], Natural Orifice Endoscopic Surgery/adverse effects [MeSH], 3. Good health, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Cholecystectomy, Laparoscopic, Vagina, Humans, Female, Aged, Retrospective Studies
Popis: PurposeHysterectomy alters the anatomy of the posterior vaginal vault used as access for transvaginal/transumbilical hybrid NOTES cholecystectomy (NC), creating potential consequences for the feasibility and complication rate of the procedure. Therefore, the aim of our retrospective analysis of prospectively collected data was to analyze the postoperative course after NC in previously hysterectomized (PH) patients compared with patients who had not undergone hysterectomy (NH).MethodsA total of 126 NH patients and 50 PH patients aged over 42 who had an NC from 12/2008 to 04/2021 were compared regarding age, body mass index (BMI), ASA classification, number of percutaneous trocars, need for intraoperative urinary bladder catheterization, length of procedure, conversion rate, and intraoperative and postoperative complication rate according to the Clavien/Dindo classification, Comprehensive Complication Index (CCI), mortality, and hospital length of stay.ResultsPH patients were older than NH patients (63.0 vs 51.5 years;P P = 0.595) and BMI (26.8 vs 27.9 kg/m2;P = 0.480). They required more percutaneous trocars (P = 0.047) and longer procedure time (66.0 vs. 58.5 min;P = 0.039). Out of all 287 scheduled NC only one had to be “converted” to traditional laparoscopic cholecystectomy. Intraoperative and postoperative complication rates, Clavien/Dindo classification, CCI, need for intraoperative urinary bladder catheterization, and length of stay did not differ significantly.ConclusionOur results indicate an increased degree of difficulty of NC in PH patients, although there is no major impact on intraoperative and postoperative complication rates. Urinary bladder perforation is a specific access-related complication in PH patients.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1435-2451
1435-2443
DOI: 10.1007/s00423-021-02401-8
Přístupová URL adresa: https://link.springer.com/content/pdf/10.1007/s00423-021-02401-8.pdf
https://pubmed.ncbi.nlm.nih.gov/34964915
https://repository.publisso.de/resource/frl:6446986
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) .
Přístupové číslo: edsair.doi.dedup.....4a54cbc6aad12ad6109ebd6166f40272
Databáze: OpenAIRE
Popis
Abstrakt:PurposeHysterectomy alters the anatomy of the posterior vaginal vault used as access for transvaginal/transumbilical hybrid NOTES cholecystectomy (NC), creating potential consequences for the feasibility and complication rate of the procedure. Therefore, the aim of our retrospective analysis of prospectively collected data was to analyze the postoperative course after NC in previously hysterectomized (PH) patients compared with patients who had not undergone hysterectomy (NH).MethodsA total of 126 NH patients and 50 PH patients aged over 42 who had an NC from 12/2008 to 04/2021 were compared regarding age, body mass index (BMI), ASA classification, number of percutaneous trocars, need for intraoperative urinary bladder catheterization, length of procedure, conversion rate, and intraoperative and postoperative complication rate according to the Clavien/Dindo classification, Comprehensive Complication Index (CCI), mortality, and hospital length of stay.ResultsPH patients were older than NH patients (63.0 vs 51.5 years;P P = 0.595) and BMI (26.8 vs 27.9 kg/m2;P = 0.480). They required more percutaneous trocars (P = 0.047) and longer procedure time (66.0 vs. 58.5 min;P = 0.039). Out of all 287 scheduled NC only one had to be “converted” to traditional laparoscopic cholecystectomy. Intraoperative and postoperative complication rates, Clavien/Dindo classification, CCI, need for intraoperative urinary bladder catheterization, and length of stay did not differ significantly.ConclusionOur results indicate an increased degree of difficulty of NC in PH patients, although there is no major impact on intraoperative and postoperative complication rates. Urinary bladder perforation is a specific access-related complication in PH patients.
ISSN:14352451
14352443
DOI:10.1007/s00423-021-02401-8