Postoperative Morbidity of Minimally Invasive Hysterectomy Approach and Uterine Size
Bibliographic record
Abstract
Background: The optimal approach to minimally invasive hysterectomy when uterine size is larger than 250 g is unclear. The aim of this study was to evaluate 30-day postoperative complications after minimally invasive hysterectomy by surgical approach and uterine size. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was searched for patients who underwent laparoscopic or vaginal hysterectomy between 2005 and 2012. Patient demographics and 30-day postsurgical complication rates were compared by hysterectomy approach and uterine size classified as either less than or equal to 250 g (small uterine size) and greater than 250 g (large uterine size) by billing codes. Multivariable regression analyses were used to study the independent effect of uterine size on outcomes. Results: Of patients undergoing hysterectomy, 31,754 (86.2%) patients had small uterine size and 5,067 (13.8%) patients had large uterine size. No surgical approach was associated with better or worse outcomes in the large uterus size group (adjusted odds ratio (aOR): 1.00, 95% CI: 0.76 - 1.30, P = 0.990). Overall morbidity was significantly more common with large uterine size than small uterine size (5.78% and 3.44%, respectively, P < 0.001). Blood transfusions were significantly more common with large than small uterine size (3.04% and 1.11%, respectively, P < 0.001). Median operative time is increased in the large uterus size group 148 minutes compared to 111 minutes in the small uterine size group (P < 0.001). Multivariable logistic regression analyses showed that uterine size was a significant predictor of overall postoperative morbidity (aOR: 1.73, 95% CI: 1.31 - 2.29). Conclusions: No approach to hysterectomy of large uteri is clearly superior in this study. Patient and surgeon preference may guide surgical approach to minimally invasive hysterectomy with large uterine size. J Clin Gynecol Obstet. 2015;4(1):153-159 doi: http://dx.doi.org/10.14740/jcgo323w
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".