Infectious morbidity risk of laparoscopic myomectomy concomitant hysteroscopy: a national surgical quality improvement program (NSQIP) analysis.
Academic Article
Overview
abstract
OBJECTIVE: We aimed to determine whether hysteroscopy at the time of laparoscopic myomectomy significantly increased the risk of surgical site infection (SSI). DESIGN: A cohort from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) retrospective database. The primary outcome was any surgical site infection within 30 days post-operatively. Further analysis of superficial, deep, and organ space infections was individually performed. Secondary outcome was post-operative urinary tract infection (UTI). Multivariate logistic regression was used to control for other risk factors for surgical site infection. The study was IRB exempt. SETTING: The ACS NSQIP database is a national validated database from academic and community hospitals. PARTICIPANTS: Individuals who had a laparoscopic myomectomy in the years 2015-2023. INTERVENTIONS: Laparoscopic myomectomy alone versus laparoscopic myomectomy with concomitant hysteroscopy. MEASUREMENTS AND MAIN RESULTS: The addition of hysteroscopy was not associated with a significant difference in the rates of any SSI (aOR 0.82; 95% CI 0.56-1.17, P=0.3), superficial SSI (aOR 0.76, 95% CI 0.48-1.14, P=0.2), deep SSI (aOR 1.59, 95 % CI 0.08-10.4, P=0.7), organ space SSI (aOR 1.23, 95% CI 0.52-2.20, P=0.7), or postoperative UTI (aOR 0.69, 95% CI 0.34-1.24, P=0.2) controlling for age, body mass index, American Society of Anesthesiologists Physical Status class, tobacco use, diabetes, blood transfusion, operative time, inpatient versus outpatient procedure, race, and presence of endometriosis. CONCLUSION: After controlling for baseline comorbidities and surgical complexity, concomitant hysteroscopy with laparoscopic myomectomy does not significantly increase 30-day rates of SSIs or postoperative UTIs.
