Objective: To evaluate the complications of different approaches of hysterectomy based on analyzing the records of patients with long post-operative hospitalization.
Methods: The records of 3722 patients undergoing hysterectomy due to benign gynecologic disorders were retrieved. A total of 162 patients with ultra-long post-operative hospitalization (> 9 days defined as delayed discharge) were analyzed to evaluate the complications of hysterectomy.
Results: (1) Of 162 patients classified into delayed discharge group, 114 (30.6 per thousand)had post-operative fever in which 82 cases (71.9%) could be explained with complications. (2) The most common procedure-related complications included pelvic hematoma/vaginal stump bleeding (n = 46, 12.4 per thousand), wound dehiscence/infection (n = 24, 6.4 per thousand), organ injury (n = 20, 5.4 per thousand), postoperative urinary retention (n = 20, 5.4 per thousand), postoperative infection(n = 20, 5.4 per thousand)and lower extremity deep venous thrombosis (n = 10, 2.7 per thousand). (3) Organ injury appeared to be relatively more common in abdominal hysterectomy than in laparoscopic and vaginal hysterectomy (7.6 per thousand, 2.1 per thousand and 0 respectively) while pelvic hematoma/vaginal stump bleeding more common in laparoscopic and vaginal hysterectomy than in abdominal hysterectomy (16.5 per thousand, 30.8 per thousand and 7.6 per thousand respectively). (4) Wound dehiscence/infection only occurred in abdominal approach and it was closely related with some concurrent disorders.
Conclusion: Complications of hysterectomy are related to the approach of surgery, disease characteristics and surgeon experiences. A more accurate evaluation of complications might be performed on the basis of the data of patients with delayed discharge.