Impact of Peritoneal Closure on Postoperative Inflammatory Response and Infection Risk in Total Laparoscopic Hysterectomy
Bibliographic record
Abstract
Objective: This study aimed to evaluate the impact of double-layer suturing, achieved through peritoneal closure, on postoperative infections and vaginal cuff dehiscence following total laparoscopic hysterectomy (TLH). Materials and Methods: A retrospective observational case series (Canadian Task Force classification II-3) was conducted at a community hospital. A total of 154 patients who underwent TLH at Fukuchiyama City Hospital in Japan between July 2019 and June 2021 were included. Peritoneal closure was performed in 126 cases, while it was omitted in 28 cases, based on the surgeon’s discretion. Results: Postoperative infections were observed in 7 out of 154 cases (4.5%). Postoperative infection occurred in 3.2% (4/126) of patients with peritoneal closure and 10.7% (3/28) of patients without peritoneal closure. Although the infection rate was lower in the peritoneal closure group, the difference was not statistically significant (odds ratio 0.36, 95% confidence interval 0.08–2.26, p = 0.15). However, inflammatory markers on postoperative day 3, including white blood cell (WBC) count and C-reactive protein (CRP), were significantly lower in the peritoneal closure group (WBC: 6,215 vs. 7,750, p = 0.001; CRP: 1.99 vs. 3.81, p = 0.003). Conclusions: Peritoneal closure at the vaginal cuff in TLH may reduce early postoperative inflammatory responses and subsequently reduce the risk of infection. Future multi-institutional studies would further delineate the optimal surgical technique for TLH and the significance of including peritoneal closure, as well as help to further define the utility of postoperative testing.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.000 | 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 teacher head, 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".