腹腔鏡下腟式子宮全摘術手術 (LAVH) の手術成績におけるBMI (body mass index) の関与に関する研究

抄録

[Purpose] The purpose of this study was to examine the effect of a patient's body shape on laparoscopic surgery. We focused on body mass index (BMI) as an index of body shape and evaluated its relevance to the outcome of laparoscopicallyassisted vaginal hysterectomy (LAVH) .
[Methods] The subjects for this study were 546 patients who underwent LAVH between July 1996 and December 2007. They were categorized into 4 groups based on the BMI calculated from their height and body weight, as follows: <18.5 (group A: underweight) ; 18.5-25 (group B: normal) ; 25-30 (group C: overweight) ; and 30< (group D: obese) . The duration of surgery, blood loss during surgery, post-operative hospital stay, and intra-operative and post-operative complications were compared among the groups. Also, in order to evaluate the relationship between BMI and duration of surgery, blood loss, and the weight of the removed uterus, the correlation among each parameter was examined.
[Results] No significant difference was observed in the surgical outcomes and complications among the four groups. No strong correlation was found between BMI and various surgical outcome parameters.
[Discussion] Generally, obesity can make surgery difficult by leading to narrowing of operative field and delayed wound healing. However, the benefit of laparoscopic surgery in obese cases has rarely been reported. Also, being underweight has been reported to be a factor which increases complications during laparoscopic surgery. In this study, BMI did not remarkably affect the outcome of LAVH. LAVH is a safe surgical method unrelated to the body habitus of patients.