Hysterectomy in women with obesity: complications related to surgical site

BACKGROUND: The aim of this study was to describe the trends in surgical routes in obese women who underwent hysterectomy for benign disease at our center and compare complications in different groups. METHODS: Retrospective study done between 2011 and 2015 in women with a Body Mass Index >= 30 who underwent hysterectomy for benign disease at Virgen de las Nieves Universitary Hospital in Granada, Spain. We studied three groups based on the surgical route chosen for hysterectomy: vaginal, abdominal or laparoscopic. The rates of intraoperative and postoperative complications, major complications, reintervention and days of hospital stay were compared. RESULTS: Abdominal hysterectomy was associated with the highest risk of postoperative complications and the longest hospital stay. Laparoscopic hysterectomy had a higher risk than vaginal hysterectomy of major complications. There were no significant differences between groups for any of the other variables. CONCLUSIONS: In obese women vaginal hysterectomy was associated with the lowest morbidity, and should be the approach of choice whenever feasible.