Association between timing of cervical excision procedure to minimally invasive hysterectomy and surgical complications. Gynecol Oncol 2017 Feb;144(2):294-298
Date
11/30/2016Pubmed ID
27894753DOI
10.1016/j.ygyno.2016.11.037Scopus ID
2-s2.0-85007106889 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
OBJECTIVE: To determine if the time interval between excision procedure and definitive minimally invasive surgery (MIS) for cervical cancer impacts 30-day postoperative complications.
METHODS: A retrospective cohort of patients diagnosed with cervical cancer from January 2000 to July 2015 was evaluated. Patients who underwent a cervical excision procedure followed by definitive MIS within 90days were included. Early definitive surgery was defined as ≤6 weeks following excision procedure, while delayed was defined as 6weeks to 3months. The primary outcome was 30-day complications. Statistical analysis included descriptive statistics and modified Poission regression.
RESULTS: Overall, 138 patients met inclusion criteria. Of these, 33% (n=46) had early definitive surgery and 67% (n=92) had delayed definitive surgery. Median age was 42years (range 23-72years) and median BMI was 28kg/m2 (range 16-50kg/m2). Within demographic and surgical factors collected, only smoking status differed between groups with those in the delayed surgery group more likely to be non-smokers than those in the early surgery group (p=0.04). When adjusting for relevant demographic and surgical factors, patients in the early group were twice as likely to have 30-day complication (aRR 2.6, 95%CI 1.14-5.76, p=0.02). Evaluating only women who underwent a radical procedure, 30-day complications remained higher in the early surgery group (RR 2.56; 95%CI 1.22-5.38, p=0.01).
CONCLUSIONS: Performing definitive MIS for cervical cancer within 6weeks after cervical excision is associated with increased risk for 30-day complications. Providers should consider delaying definitive surgical procedures for at least 6weeks following excision to reduce surgical complications.
Author List
Sullivan SA, Clark LH, Staley AS, Tran AQ, Winn A, Kim KHMESH terms used to index this publication - Major topics in bold
AdultAged
Cervix Uteri
Female
Humans
Hysterectomy
Middle Aged
Minimally Invasive Surgical Procedures
Postoperative Complications
Time Factors
Uterine Cervical Neoplasms