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The impact of the body mass index (BMI) on laparoscopic hysterectomy for benign disease

David Bardens, Erich Solomayer, Sascha Baum, Julia Radosa, Stefan Gräber, Achim Rody, Ingolf Juhasz-Böss
Archives of Gynecology and Obstetrics 2014, 289 (4): 803-7

PURPOSE: To investigate the influence of the body mass index (BMI) on laparoscopic hysterectomy, including all intra- and postoperative findings and complications.

METHODS: We reviewed and analyzed the medical records of 200 patients who underwent laparoscopic hysterectomy for benign disease at the Saarland University Hospital. The patient collective was subdivided into four weight groups on the basis of the current WHO BMI classification. Data analysis was carried out by a professional statistician.

RESULTS: Over half of the women screened were overweight or obese. The operating times increased together with the BMI (p = 0.017). Blood losses differed significantly between the weight groups (p = 0.027), but ranged to a maximum of only 300 ml. One laparoconversion had to be performed. No other intraoperative complications occurred. During our follow-up time of 13.2 ± 5.4 months, the overall rate of postoperative complications differed significantly between the weight groups (p = 0.008). The group of overweight women had the highest rate of complications and the group of obese women had the lowest. However, the rate of women who required readmission and reoperation was not elevated in the overweight group.

CONCLUSION: Laparoscopic hysterectomy is a safe and feasible method even in obese and morbidly obese patients. Overweight and obesity increase the time needed to perform laparoscopic hysterectomy but do not seem to relevantly influence the rate of major intra- or postoperative complications.

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