Editorial comment

Excerpt

Gynecologic Surgery received a letter pointing to potential errors in the paper from Wiser et al., previously published in the journal [1]. They reported on a retrospective cohort study using the data from the Health Cost and Utilization Project Nationwide Inpatient Sample including data on 465,798 women who were admitted for hysterectomy for benign diseases between the years 2002 and 2008. Of the women admitted, 389,189 (83.6 %) underwent abdominal hysterectomy (AH) and the remainder underwent laparoscopic hysterectomy (LH; 76,609, 16.4 %). In-hospital morbidities and mortalities were identified using the diagnostic and procedural codes classified according to the International Classification of Disease, Ninth Revision, and Clinical Modification. Multivariable logistic regression analysis was used to estimate the relationship between the type of hysterectomy and the development of major morbidity and mortality. The data showed that women who underwent LH were less likely to develop thromboembolic events (0.69 vs. 0.84 %, adjusted odds ratio (aOR) 0.85 (0.77–0.93)), to require blood transfusions (2.4 vs. 4.7 %, aOR 0.58 (0.55–0.61)), or have bowel perforation (0.07 vs. 0.13 %, aOR 0.56 (0.42–0.74)). Also, the mortality rate was lower in the LH group (0.01 %) compared with the AH group (0.03 %, aOR 0.48 (0.24–0.95)). The authors concluded that “when possible”, hysterectomy for benign diseases should be performed with minimally invasive technique due to the lower complication rates. …