Hysterectomy and panniculectomy can be performed simultaneously without increasing risk of complications, reports a study in the September issue of Plastic and Reconstructive Surgery®.
Researchers tapped into a national surgical database to identify more than 25,000 women who underwent hysterectomy between 2005 and 2012. Of these, 174 underwent panniculectomy during the same operation.
Thirty-day complication rates were compared for matched groups of women undergoing hysterectomy plus panniculectomy versus hysterectomy alone. Patients undergoing hysterectomy plus panniculectomy were more likely to be obese, to have diabetes, and to have a history of heart or lung disease. Median surgical time was twice as long in the combined surgery group: about 4 hours, compared to 2 hours for hysterectomy alone.
Overall, women undergoing hysterectomy plus panniculectomy had a higher rate of blood clot-related complications called venous thromboembolism (VTE): 3% versus 1%. Women in the combined group were also more likely to stay in the hospital for 3 days or longer: 48% versus 29%.
When comparing the matched groups of patients with similar characteristics, however, the researchers found no significant difference in VTE risk. There was also no difference in wound complications, surgical-site infections, medical complications, or total complication rate, the study showed. “This highlights the critical importance of patient selection for avoiding complications in combined procedures,” says lead author Antonio Jorge Forte, MD, a plastic surgeon at the Yale School of Medicine in New Haven, Conn, in a news release.
The difference in length of hospital stay remained significant. Women undergoing hysterectomy plus panniculectomy were twice as likely to spend at least 3 days in the hospital.
“This is among the best evidence to date regarding 30-day risk profiles, and the data suggests that the complication rates are comparable for patients undergoing combined hysterectomy and panniculectomy versus hysterectomy alone,” Forte says.” However, these patients should be counseled to expect to stay longer in the hospital after combined procedures.”