Safety of Laparoscopic Surgery in Gynecologic Emergencies: Comparative Analysis with and without Previous Abdominopelvic Surgery
DOI:
https://doi.org/10.36570/jduhs.2023.2.1622Keywords:
Gynecologic, Laparoscopic, Safety, SurgeriesAbstract
Objective: To determine the safety of laparoscopic surgery with and without history of previous abdominopelvic surgeries among women undergoing gynecological emergencies in a private tertiary care hospital of Karachi.
Methods: This analytical comparative study was conducted at Patel Hospital from Jan 2018 to Jan 2020. The study included all non-pregnant and pregnant women aged 16 years and above diagnosed with acute abdomen pain due to gynecological causes. Patients divided into two groups on the basis of their presence or absence of history of abdominopelvic surgeries. Safety was defined based on risk/frequency of organ injury, amount of blood lose, need of per-operative transfusion and surgical time. Post-operatively the safety was measure by duration of hospital stay, post operative pyrexia, and wound infection.
Results: Of 92 women, the mean age was 28.6±6.5 years. There were 36 (39.1%) women with previous abdominopelvic surgical history and 56 (60.9%) without previous abdominopelvic surgical history. No significance difference of blood loss (p-value 0.382) and duration of hospital stay (p-value 0.475) were observed in both groups. However, duration of surgery was the only variable which was found significantly different in both groups (p-value 0.018). Among 56 patients with no previous abdominopelvic surgery, pre-operative transfusion was found in 14 (25%) and post-operative pyrexia in only 2 (3.6%) patients. Whereas none of the patients in both groups reported wound infection or organ injury.
Conclusion: Laparoscopic procedures are safe to use in gynecological emergencies for both diagnostic and therapeutic purposes regardless of presence of history of abdominopelvic surgeries.
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Puntambekar S, Telang M, Kulkarni P, Jadhav S, Sathe R, Warty N, Laparoscopic-assisted uterus retrieval from live organ donors for uterine transplant. J Minim Invasive Gynecol 2018; 25:571-2. doi:10.1016/j.jmig.2017.11.001 572
Kilonzom A. The Role of Laparoscopy in the Managem-ent of Gynecologic Surgical Emergencies: A Review of Literature. World J Laparosc Surg 2010; 3:127-130.
Kolmorgen K. Laparoscopy complications in previously operated patients. Zantralbl Gynakol 1998; 120:191-4.
Mac Cordick C, Lecuru F, Rizk E. Morbidity of laparo-scopy for gynaecological surgery; Results of a prospective monocenter study. J Soc Laparasc Robot Surg 2001; 5: 13–6.
Negoi I, Paun S, Filipoiu F. Peritoneal Adhesions does not represent a contraindication for minimally invasive approach in Gynecological emergencies. Romanian Journal of Functional & Clinical, Macro- & Microscopical Anatomy & of Anthropology 2015; 14:p264-7.
Roviaro GC, Varoli F, Saguatti L. Major vascular injuries in laparoscopic surgery. Surg Endosc 2002; 16:1192-6.
Hazim W, Ramli R. Impact of Previous Abdominal Surgery on Laparoscopic Cystectomy/Oophorec-tomy Results: A Comparative Clinical Study. Int Med J Malaysia 2012; 11. 29-33
Krishnakumar S, Tambe P. Entry complications in lapa-roscopic surgery. J Gynecol Endosc Surg 2009; 1:4-11.
Herrmann A, Torres-de la Roche LA, Krentel H, Cezar C, de Wilde MS, Devassy R, et al. Adhesions after laparoscopic myomectomy: incidence, risk factors, complications, and prevention. Gynecol Minim Invasive Ther 2020; 9:190-7.
doi:10.4103/GMIT.GMIT_87_20
Sanguandeekul N, Vallibhakara O, Arj-Ong Vallibhakara S, Sophonsritsuk A. Gastrointestinal injuries during gynaecologic operations at a university teaching hospital in Thailand: a 10-year review. J Obstet Gynaecol 2019; 39:384-8.
doi:10.1080/01443615.2018.1525692
Zi D, Guan Z, Ding Y, Yang H, Thigpen B, Guan X. Critical steps to performing a successful single-site laparoscopic myomectomy for large pedunculated myoma during pregnancy. J Minim Invasive Gynecol 2022; 29:818-9.
doi:10.1016/j.jmig.2022.04.012
Magos AL, Baumann R, Turnbull AC. Managing gynaecological emergencies with laparoscopy. BMJ 1989; 299:371-4.
Aulestia S N, Cantele H, Leyba J L, Navarrete M, Llopla SN. Laparoscopic diagnosis and treatment in gynecologic emergencies. JSLS 2003; 7:239-242.
Neugebauer EA, Sauerland . Guidelines for emergency laparoscopy. World J Emerg Surg 2006; 1:31.
Brill AI, Nezhat F, Nezhat CH, Nezhat C. The incidence of adhesions after prior laparotomy: a laparoscopic appraisal. Obstet Gynecol 1995; 85:269-72.
Fuentes MN, Rodriguez-Oliver A, Naveiro Rilo JC, Paredes AG, Aguilar Romero MT, Parra JF. Complications of laparoscopic gynecologic surgery. JSLS 2014; 18:e2014.00058.
doi:10.4293/JSLS.2014.00058
Kumakiri J, Kikuchi I, Kitade M, Kurodak, Matsuokas, Tokitas, et al. Incidence of complications during gynecologic laparoscopic surgery in patients after previous laparotomy. J Minim Invasive Gynecol 2010; 17:480-6. doi:10.1016/j.jmig.2010-03.004.
Maccio A, Chiappe G, Kotsonis P, Lavra F, Nieddu R, Onnis P, et al. The utility of fibrinogen level as a predictor of complications after laparoscopic gynecologic surgery: a prospective observational study. Gynecol Surg 2019; 16:1-8.
doi:org/10.1186/s10397-019-1064-x
Tanos V, Berry KE, Frist M, Campo R, DeWilde RL. Prevention and management of complications in laparoscopic myomectomy. Biomed Res Int 2018; 2018:8250952. doi:10.1155/2018/8250952
Sizzi O, Rossetti A, Malzoni M, Minelli L, La Grotta F, Soranna L, et al. Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol 2007; 14:453-62.
doi:10.1016/j.jmig.2007.01.013
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