The Effect of a Previous Laparoscopic Surgery on the Risk for Peri- and Postoperative Complications of Vaginal Hysterectomy

Abstract

Objectives:

To investigate whether a previous laparoscopic surgery (LS) increases the risk of peri- and postoperative complications during vaginal hysterectomy (VH).

Methods:

A retrospective cohort study of patients who had undergone a VH for benign indications between 2014 and 2019 was conducted. The study population was divided into two groups, women with or without a previous laparoscopic surgery. Peri- and postoperative complications were assessed according to the Clavien–Dindo classification system within 30 days of surgery. Estimated blood loss, duration of surgery, and postoperative hospitalization days were also recorded. All analyses with a two-sided p-value of ≤ 0.05 were considered significant.

Results:

Of 240 women who underwent VH during the study period, 160 had no history of laparoscopic surgery, and the remainder (n = 80) had undergone a previous laparoscopy (study group). Women in the study group had a lower mean estimated blood loss during VH (p < 0.01) and a higher median of postoperative hospitalization days (p = 0.05). A previous LS was not found to be associated with a higher grade of peri- and postoperative complications according to the Clavien–Dindo classification (p > 0.05). We performed a sub-analysis dividing previous LS (gynecological vs. other) and found that 76.5% of patients with GYN LS had complications (grade I–IV) compared with 34.9% (p-value = 0.002).

Conclusion:

VH for benign indications has an acceptable complication rate and can be safely performed regardless of a previous LS. Previous pelvic LS may increase the risk for minor complications during VH.