Complications of Total Abdominal Hysterectomy for Benign Gynecological Disease: Experience from a High Specialty Center in Mexico City

Abstract

Aims: To identify the frequency and type of complications of total abdominal hysterectomy (TAH) in a retrospective cohort of patients with benign gynecological pathology. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gynecology from High Specialty Medical Unit, Gynecology and Obstetrics Hospital No. 3 of the National Medical Center "La Raza". Mexican Institute of Social Security, Mexico City between January 1 to December 31, 2024. Methodology: The frequency and type of surgical and postoperative complications in a retrospective cohort of 139 patients were studied. Data were compared between patients without complications and those with complications according to gynecological pathology, TAH technique, body mass index (BMI), surgical time, estimated bleeding, transfusion, intensive care, hospital stay and mortality. Data were analyzed using descriptive and inferential statistics (Kolmogorov-Smirnov, Mann-Whitney U and Chi-square tests); a P value <.05 was considered significant. The statistical program SPSS™ version 22 was used. Results: The complication rate was 20.14% (28 complications), which occurred in 13.67% of patients (n=19/139). Patients with one complication n=13, two complications n=3, and three complications n=3. Types: hemorrhage (n=11), infections (n=9), reoperation (n=5), and bladder injury (n=3). Gynecological pathology: leiomyomatosis 69.06%, uterine prolapse 5.94%, abnormal uterine bleeding 9.35%, other 16.55%. Patients with complications had a higher BMI (P=.001), prolonged surgical time (P=.001), increased bleeding (P=.001), transfusion requirement (47.37%, n=9/19), and longer hospital stay (P=.001), with intensive care 0% and mortality 0%. Conclusion: The incidence of complications was high. The main complication was blood loss, both during surgery and postoperative period. Based on the findings, a series of practical recommendations can be made to improve results.