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Comparison of urologic complications between laparoscopic radical hysterectomy and abdominal radical hysterectomy: A nationwide study from the National Health Insurance.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2020 Jul; Vol. 158 (1), pp. 117-122. Date of Electronic Publication: 2020 Apr 27. - Publication Year :
- 2020
-
Abstract
- Objective: This study aimed to assess the risks of intraoperative and postoperative urologic complications between laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH).<br />Methods: Using the database of the National Health Insurance Service (NHIS) and Health Insurance Review & Assessment (HIRA), we identified all Korean women who underwent radical hysterectomy between 2006 and 2018. Intraoperative and postoperative urologic complications were compared between the ARH and LRH groups.<br />Results: A total of 11,399 patients were identified to ARH and 8435 patients to LRH. Urologic complications occurred in 292 of 19,774 patients (1.48%) who underwent radical hysterectomy. LRH was associated with higher complication rates than ARH, although with a borderline significance (OR: 1.23; 90% CI: 1.02-1.51, p = 0.066). There was no difference in intraoperative urologic complications between the ARH and the LRH groups (OR: 1.1 95% CI: 0.86-1.43, p < 0.435). The incidence of postoperative urologic complications was significantly higher in the LRH group (OR: 2.01; 95% CI: 1.18-3.47, p = 0.009). In terms of postoperative urologic complications, the risk of ureterovaginal fistula was not significant between the two groups (OR: 1.53; 95% CI: 0.54-4.24, p = 0.403), whereas the risk of vesicovaginal fistula was significantly higher in the LRH group (OR: 2.24; 95% CI: 1.09-4.58, p = 0.028). There were no significant differences in the overall and urinary tract-specific complications between ARH and LRH in groups under 40 years of age and during the second half (2013-2018), with 2012 as the boundary.<br />Conclusion: Among specific urologic complications, the incidence of vesicovaginal fistula was significantly higher in the LRH group than in the ARH group.<br />Competing Interests: Declaration of competing interest There are no conflicts of interest relevant to this study.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Female
Humans
Hysterectomy adverse effects
Hysterectomy methods
Incidence
Laparoscopy adverse effects
Laparoscopy methods
Laparoscopy statistics & numerical data
Middle Aged
Postoperative Complications epidemiology
Postoperative Complications ethnology
Republic of Korea epidemiology
Urologic Diseases etiology
Vesicovaginal Fistula epidemiology
Vesicovaginal Fistula etiology
Hysterectomy statistics & numerical data
Urologic Diseases epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 158
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 32354468
- Full Text :
- https://doi.org/10.1016/j.ygyno.2020.04.686