Obstet Gynecol Sci.  2014 Mar;57(2):136-143.

Evaluation of risk factors of vaginal cuff dehiscence after hysterectomy

Affiliations
  • 1Korea University School of Medicine, Seoul, Korea.
  • 2Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul, Korea. sjyuni105@gmail.com
  • 3Department of Obstetrics and Gynecology, Korea University Guro Hospital, Seoul, Korea.
  • 4Department of Obstetrics and Gynecology, Korea University Ansan Hospital, Ansan, Korea.

Abstract


OBJECTIVE
The purpose of this study was to evaluate risk factors of vaginal cuff dehiscence or evisceration according to the type of operation.
METHODS
Medical records of 604 women who underwent hysterectomies at Korea University Anam Hospital between June 2007 and June 2011 were reviewed. They were allocated to six groups. The six types of hysterectomies included robotic hysterectomy (n = 7), robotic radical hysterectomy and node dissection (RRHND, n = 9), total laparoscopic hysterectomy (TLH, n = 274), laparoscopy assisted vaginal hysterectomy (LAVH, n = 238), laparoscopic radical hysterectomy and node dissection (n = 11), and abdominal radical hysterectomy (ARH, n = 63). The characteristics and outcomes of each groups were compared.
RESULTS
There was no difference in the characteristics of patients between 6 groups. In total of 604 hysterectomies, 3 evisceration (0.49%) and 21 dehiscences (3.47%) occurred. Evisceration were found in RRHND (1/9, 11.1%), TLH (1/276, 0.36%), and ARH (1/63, 1.56%). Dehiscences occurred in TLH (15/274, 5.42%), LAVH (4/238, 1.68%), and ARH (2/63, 3.17%). In 169 cases of TLH with intra-corporeal continuous suture, 1 evisceration and 4 dehiscences occurred, whereas 11 dehiscences occurred in 105 TLH cases with vaginal continuous locking suture (2.96% vs. 10.47%, P = 0.02).
CONCLUSION
The incidence of vaginal cuff dehiscenceand eviscerationwas significantly higher in TLH than LAVH. The intra-corporeal cuff suture was superior to the vaginal suture to prevent the vaginal cuff complications in TLH.

Keyword

Complications; Hysterectomy; Surgical wound dehiscence; Suture techniques
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