婦人科良性疾患に対して施行したTLHの周術期合併症について

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Objective: The aims of this study were to clarify changes over time in surgery for benign gynecological disorders and to evaluate the perioperative complications of total laparoscopic hysterectomy (TLH).

Methods: This retrospective study included data of 262 patients who had undergone TLH for benign disease from January 2013 to December 2019. TLH was performed after determining on the basis of tumor markers and MRI that there was a low risk of malignant disease.

Results: Results: During the study period, 713 patients underwent abdominal hysterectomy for benign diseases, comprising abdominal hysterectomy in 432 patients, TLH in 262, and robotic-assisted surgery (RAS) in 19. From 2013 to 2015, TLH was performed on around 10% of patients; this percentage increased to around 50% from 2016. There were 12 perioperative complications in the 262 patients who had undergone TLH, comprising five intraoperative and seven postoperative complications. Perioperative complications comprised ureteral injury in two patients, bladder injury in two, and rectal injury in one. Postoperative complications comprised vaginal stump abscess in three patients, ureteral fistula in one, compartment syndrome in one, malignant hyperthermia in one, and open wound in one.

Conclusions: In this study, we investigated the complications of TLH. To achieve better outcomes of TLH, improvement in performance and safety of surgical procedures is important.