Postoperative outcomes in minimally invasive total versus supracervical hysterectomy for endometriosis: a NSQIP study

• Published in: Archives of gynecology and obstetrics 2024-10
• Main Authors: Meyer, Raanan, McDonnell, Jill, Hamilton, Kacey M, Schneyer, Rebecca J, Levin, Gabriel, Wright, Kelly N, Siedhoff, Matthew T
• Format: Article
• Language: English
• ISSN: 1432-0711; 1432-0711
• DOI: 10.1007/s00404-024-07749-y

To study the rate and odds of 30 day postoperative complications among patients undergoing minimally invasive total (TLH) compared to supracervical (LSCH) hysterectomy for endometriosis. A cohort study of patients with a diagnosis of endometriosis undergoing hysterectomy. We used prospectively collected data from the American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2020. We compared short-term (30 day) complications, following minimally invasive TLH and LSCH for endometriosis. The primary outcome was the risk of any postoperative complications according to the surgical approach. A total of 5,278 patients were included, 4,952 (93.8%) underwent TLH and 326 (6.2%) underwent LSCH. The incidence of any complication was significantly lower in the LSCH group compared to the TLH group (3.7% vs. 8.5%, p = .001). Both major complications (1.5% vs. 3.7%, p = 0.043) and minor complications (2.8% vs. 5.4%, p = .039) were less frequent in the LSCH group compared to the TLH group. In multivariable regression analysis, patients undergoing LSCH had significantly lower odds of any complication [aOR 95%CI 0.40 (0.22-0.72)], and of minor complications [aOR 95%CI 0.47 (0.24-0.92)] compared to TLH. LSCH is associated with a lower odd of short-term postoperative complications compared to TLH for patients with endometriosis.