Abstract

Introduction: Benign uterine tumors, such as fibroids and adenomyosis, affect up to 40% of women of reproductive age, causing symptoms such as abnormal menstruation, anemia, abdominal discomfort, and infertility. Minimally involves surgery (MIS) are the mainstream choice of treatment due to a shortened surgical duration and recovery time as well as decreased blood loss when compared with open surgery. This study seeks to explore the differences in postoperative care depending on the method of MIS involved.

Methods: This is a retrospective study on women who underwent gynecological surgeries from January 1, 2018, to December 31, 2021 in a hospital in southern Taiwan . A total of 673 patients were followed for one year, with data analyzed using SPSS, including chi-square tests, t-tests, and logistic regression to identify factors affecting postoperative care quality.

Results: The average age of patients was 42.45± 7.29 years, and the average hospital stay was 2.36± 1.81 days. Most common surgery was laparoscopic myomectomy (70%), followed by laparoscopic subtotal hysterectomy (16.9%) and tumor ablation (13.1%). Significant factors influencing postoperative complications included BMI (χ2 = 9.259, p = 0.026) and tumor size(χ2 = 25.682, p = 0.000) . Independent t-tests showed significant differences in hospitalization duration related to menstrual pain (p = 0.04), tumor size (p = 0.00), hemoglobin levels (p = 0.00), and menstrual bleeding volume (p = 0.01). Logistic regression analysis indicated that patients with BMI >27kg/m2 = 3.356 times the risk of postoperative complications compared to those with a BMI of 18.5–24 kg/m2(β=3.356, p=0.048) and 5.635 times the risk compared to those with BMI 24–27kg/m2 (β=5.635, p=0.007). Tumors ≥ 4 cm were significantly associated with postoperative complications (β=0.264, p=0.000). Laparoscopic total hysterectomy was associated with a reduced risk of reoperation within a year compared to uterine tumor ablation (β=0.294, p=0.036).Larger tumors and higher BMI were associated with increased complications. Logistic regression showed that patients with BMI >27kg/m2 or tumors ≥4 cm are statistically significant to be associated with an increased risk of postoperative complications. Laparoscopic subtotal hysterectomy patients had a lower risk of repeated operation with to other methods.

Notes

References:

Bofill Rodriguez, M., Lethaby, A., & Fergusson, R. J. (2021). Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. Cochrane Database Syst Rev, 2(2), Cd000329. doi:10.1002/14651858.CD000329.pub4

Cooper, Kevin, Breeman, Suzanne, Scott, Neil W, Scotland, Graham, Clark, Justin, Hawe, Jed, . . . Wileman, Samantha. (2019). Laparoscopic supracervical hysterectomy versus endometrial ablation for women with heavy menstrual bleeding (HEALTH): a parallel-group, open-label, randomised controlled trial. The Lancet, 394(10207), 1425-1436.

Jeng, C. J., Ou, K. Y., Long, C. Y., Chuang, L., & Ker, C. R. (2020). 500 Cases of High-intensity Focused Ultrasound (HIFU) Ablated Uterine Fibroids and Adenomyosis. Taiwan J Obstet Gynecol, 59(6), 865-871. doi:10.1016/j.tjog.2020.09.013

Keil, D. S., Schiff, L. D., Carey, E. T., Moulder, J. K., Goetzinger, A. M., Patidar, S. M., . . . Schoenherr, J. W. (2019). Predictors of Admission After the Implementation of an Enhanced Recovery After Surgery Pathway for Minimally Invasive Gynecologic Surgery. Anesth Analg, 129(3), 776-783. doi:10.1213/ane.0000000000003339

Ricci, G., Scrimin, F., Sartore, A., Borelli, M., Zito, G., Romano, F., & Stabile, G. (2022). Characteristics of Submucous Myomas and the Risk of Anemia. Medicina (Kaunas), 58(11). doi:10.3390/medicina58111652

Schmidt, P. C., Kamdar, N. S., Erekson, E., Swenson, C. W., Uppal, S., & Morgan, D. M. (2022). Development of a Preoperative Clinical Risk Assessment Tool for Postoperative Complications After Hysterectomy. J Minim Invasive Gynecol, 29(3), 401-408.e401. doi:10.1016/j.jmig.2021.10.008

Description

Benign uterine tumors Patients with a BMI >27 kg/m2 or tumors ≥4 cm had a higher risk of postoperative complications. Those with menstrual pain, larger tumors, low hemoglobin, or prolonged bleeding had longer hospital stays. Laparoscopic subtotal hysterectomy was associated with fewer reoperations. These findings can guide clinicians in improving preoperative assessments and postoperative care.

Author Details

Chia Yu Chen, Master's Degree; Liang-Chun Chiu, MD

Sigma Membership

Non-member

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Sub-acute Care, Gynecological Diseases, Laparoscopic Total Hysterectomy, High-Intensity Focused Ultrasound (HIFU), Care Quality

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the poster.

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Postoperative Care Quality in Gynecological Surgery Techniques

Seattle, Washington, USA

Introduction: Benign uterine tumors, such as fibroids and adenomyosis, affect up to 40% of women of reproductive age, causing symptoms such as abnormal menstruation, anemia, abdominal discomfort, and infertility. Minimally involves surgery (MIS) are the mainstream choice of treatment due to a shortened surgical duration and recovery time as well as decreased blood loss when compared with open surgery. This study seeks to explore the differences in postoperative care depending on the method of MIS involved.

Methods: This is a retrospective study on women who underwent gynecological surgeries from January 1, 2018, to December 31, 2021 in a hospital in southern Taiwan . A total of 673 patients were followed for one year, with data analyzed using SPSS, including chi-square tests, t-tests, and logistic regression to identify factors affecting postoperative care quality.

Results: The average age of patients was 42.45± 7.29 years, and the average hospital stay was 2.36± 1.81 days. Most common surgery was laparoscopic myomectomy (70%), followed by laparoscopic subtotal hysterectomy (16.9%) and tumor ablation (13.1%). Significant factors influencing postoperative complications included BMI (χ2 = 9.259, p = 0.026) and tumor size(χ2 = 25.682, p = 0.000) . Independent t-tests showed significant differences in hospitalization duration related to menstrual pain (p = 0.04), tumor size (p = 0.00), hemoglobin levels (p = 0.00), and menstrual bleeding volume (p = 0.01). Logistic regression analysis indicated that patients with BMI >27kg/m2 = 3.356 times the risk of postoperative complications compared to those with a BMI of 18.5–24 kg/m2(β=3.356, p=0.048) and 5.635 times the risk compared to those with BMI 24–27kg/m2 (β=5.635, p=0.007). Tumors ≥ 4 cm were significantly associated with postoperative complications (β=0.264, p=0.000). Laparoscopic total hysterectomy was associated with a reduced risk of reoperation within a year compared to uterine tumor ablation (β=0.294, p=0.036).Larger tumors and higher BMI were associated with increased complications. Logistic regression showed that patients with BMI >27kg/m2 or tumors ≥4 cm are statistically significant to be associated with an increased risk of postoperative complications. Laparoscopic subtotal hysterectomy patients had a lower risk of repeated operation with to other methods.