The Influence of Obesity on Non-Descent Vaginal Hysterectomy (NDVH): A Retrospective Comparison of Obese and Non-Obese Women Undergoing NDVH | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 140, Volume 93, Issue 1, October 2023, Page 7831-7839 PDF (448.91 K) | ||||
| DOI: 10.21608/ejhm.2023.331762 | ||||
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| Abstract | ||||
| Background: High body mass index (BMI) ≥ 30 kg/m2 is associated with non-optimal perioperative consequences in women undergoing hysterectomy and is deemed a contraindication for non-descent vaginal hysterectomy (NDVH) by utmost gynecologic surgeons, is this contraindication authentic or assumed? Objective: To estimate the influence of BMI on perioperative outcomes in patients who underwent NDVH for non-malignant uterine disorders. Patients and Methods: This retrospective cohort involves 843 patients; 413 patients were non-obese (BMI < 30 kg/m2) and 430 patients were obese (BMI ≥ 30 kg/m2). Results: BMI differed significantly between groups (27.4±6.7 vs. 38.6±11.6, P= 0.0001). Both groups also differed regarding age, parity, preoperative medical comorbidity including hypertension and diabetes mellites, American Society of Anesthesiologists physical status, and endometrial hyperplasia incidence (P<0.05), but were parallel concerning nulliparity, menopausal status, number of prior vaginal birth prior cesarean section, and virgin lower abdomen. No clinically significant alterations were perceived in perioperative consequences as transfusion, ureteral, bladder, or bowel injuries, fever, systemic infections, fistula, conversion to total abdominal hysterectomy, and total postoperative complications. Obese group was associated with significant excess operative blood loos, extended total and actual operative room time, longer postoperative hospital stays, higher rate of deep venous thrombosis (DVT), excess need for general aesthesia, analgesia and venous thromboembolism (VTE) prophylaxis (P<0.05). Conclusions: The outcomes regarding intraoperative conversion to TAH and perioperative consequences disclose that NDVH is safe and feasible for patients with BMI ≥ 30 kg/m2 and gynecologist shouldn’t consider obesity, even morbid or super or more, as a contraindication for NDVH. | ||||
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