Hysterectomy in very obese and morbidly obese patients: a systematic review with cumulative analysis of comparative studies

Archives of Gynecology and Obstetrics
Mathijs D BlikkendaalFrank Willem Jansen

Abstract

Some studies suggest that also regarding the patient with a body mass index (BMI) ≥35 kg/m(2) the minimally invasive approach to hysterectomy is superior. However, current practice and research on the preference of gynaecologists still show that the rate of abdominal hysterectomy (AH) increases as the BMI increases. A systematic review with cumulative analysis of comparative studies was performed to evaluate the outcomes of AH, laparoscopic hysterectomy (LH) and vaginal hysterectomy (VH) in very obese and morbidly obese patients (BMI ≥35 kg/m(2)). PubMed and EMBASE were searched for records on AH, LH and VH for benign indications or (early stage) malignancy through October 2014. Included studies were graded on level of evidence. Studies with a comparative design were pooled in a cumulative analysis. Two randomized controlled trials, seven prospective studies and 14 retrospective studies were included (2232 patients; 1058 AHs, 959 LHs, and 215 VHs). The cumulative analysis identified that, compared to LH, AH was associated with more wound dehiscence [risk ratio (RR) 2.58, 95 % confidence interval (CI) 1.71-3.90; P = 0.000], more wound infection (RR 4.36, 95 % CI 2.79-6.80; P = 0.000), and longer hospital admission (mean differen...Continue Reading

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Citations

Feb 11, 2016·Archives of Gynecology and Obstetrics·Christos Iavazzo, Ioannis D Gkegkes
Nov 28, 2015·Journal of Minimally Invasive Gynecology·Sara R C DriessenFrank Willem Jansen
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Jun 9, 2020·Archives of Gynecology and Obstetrics·Diego RaimondoRenato Seracchioli
Mar 16, 2017·Archives of Gynecology and Obstetrics·Banghyun LeeYong Beom Kim
Aug 25, 2019·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Paul J YongCatherine Allaire
Aug 25, 2019·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Paul J YongCatherine Allaire
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May 27, 2021·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Cihan KayaLevent Yaşar

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Methods Mentioned

BETA
hysterectomy
hysterectomies
dissection

Software Mentioned

Review Manager
SPSS

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