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Intraoperative and Postoperative Gastrointestinal Complications Associated With Laparoscopic Sacrocolpopexy

Warner, William B. MD*; Vora, Sonali MD; Alonge, Angela BS; Welgoss, Jeffrey A. MD; Hurtado, Eric A. MD; von Pechmann, Walter S. MD

Female Pelvic Medicine & Reconstructive Surgery: November/December 2012 - Volume 18 - Issue 6 - p 321–324
doi: 10.1097/SPV.0b013e3182724648
Original Articles

Objective This study aimed to quantify the risks of intraoperative and postoperative gastrointestinal (GI) complications associated with laparoscopic sacrocolpopexy and identify possible risk factors.

Methods A total of 390 medical records were retrospectively reviewed for GI complications. Complications were classified as functional complications [ileus, small bowel obstruction (SBO), and prolonged nausea/emesis] or bowel injury. Nausea/emesis was considered prolonged if these symptoms resulted in a hospital stay of greater than 48 hours, or in readmission.

Results Functional GI complications included 1 ileus, 3 SBOs, and 3 cases of prolonged nausea/emesis. The combined rate for ileus and SBO was 1.0% and the rate of prolonged nausea/emesis was 0.8%. Functional GI complications were associated with prior abdominal surgery (P = 0.048), but there were no differences in age, body mass index, estimated blood loss, or operative time.

There were 3 small bowel and 2 rectal injuries for a bowel injury rate of 1.3%. Bowel injury was not associated with prior abdominal surgery (P = 0.071), age, body mass index, estimated blood loss, or operative time. The total reoperation rate for SBO or bowel injury was 0.8%.

Conclusions The rates of GI complications in laparoscopic sacrocolpopexy are low. Prior abdominal surgery was associated with an increased risk of functional GI complications, but not bowel injury. This information should assist surgeons with preoperative patient counseling.

Gastrointestinal complications following LSC are rare, though they account for a significant portion of the morbidity associated with the procedure.

From the *Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, MD; †Department of Obstetrics and Gynecology, George Washington University School of Medicine, Washington, DC; and ‡Inova Fairfax Hospital, Falls Church, VA.

Disclosures: Jeffrey A. Welgoss is on the Medtronic speakers’ bureau.

Presented at the 38th Annual SGS Scientific Meeting, April 2012, Baltimore, MD.

This is an IRB-approved study at Inova Fairfax Hospital, Protocol #11.008.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, the Department of Defense, or the US Government.

We certify that all individuals who qualify as authors have been listed; each has participated in the conception and design of this work, the writing of the document, and the approval of the submission of this version; that the document represents valid work; that if we used information derived from another source, we obtained all necessary approvals to use it and made appropriate acknowledgments in the document; and that each takes public responsibility for it.

Nothing in the presentation implies any Federal/DOD endorsement.

No financial support was received for this research study.

© 2012 by Wolters Kluwer Health | Lippincott Williams & Wilkins