Incidence of Febrile Morbidity after Laparoscopic-Assisted Vaginal Hysterectomy in Srinagarind Hospital

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Iyara Wongpia
Kovit Khampitak
Jadsada Thinkhamrop

Abstract

Background and objective: Postoperative fever is the most commonly reported adverse event and prophylactic antibiotics were used in all cases.  The objective of this study was to assess  the incidence  of  postoperative febrile morbidity and the cost of laparoscopic assisted vaginal hysterectomy (LAVH) in Srinagarind Hospital.

Methods: Medical records of women with benign gynaecologic conditions who underwent laparoscopically assisted vaginal hysterectomy between 1 June 2007 and 31 May 2012 at Srinagarind Hospital were reviewed. The data extraction were recorded to the case record forms in order to assess their baseline characteristics, the number of post-operative febrile morbidity, and possible related risk factors, and their expenditure during hospitalization.

Results: A total of 199 LAVH procedures were performed from 1 June 2007 to 31 May 2012.The study revealed that mean age 46 ± 6 years, BMI 24.02 ± 3.18 kg., the mean number of child birth was 2 ± 2, the mean duration of the operations were 134 ± 52 minutes, estimated blood loss 259 ml., the postoperative hospital stay 5 ± 2 days. Major intraoperative complications occurred in  3 cases : bladder injury in 1 case (0.5%) bowel injury  1 case (0.5%).Major long-term complications occurred  in one case were ureterovaginal fistula. (0.5%).The antibiotic usage: one  type in 156 cases (78.39%) , two types in 38 cases (19.9%), and three  type in 5 cases (4.52%). Single dose-preoperation  in 26 cases (13.6%) 1 day-postoperation in 51 patients (25.63%) 3 days-postoperation in 103 cases (51.76%) 5 days-postoperation in 12 cases (6.03%) and postoperation  7 days in 7 cases (3.52%). Postoperative febrile morbidity  after  LAVH were 31 cases (15.58%) and causes of postoperative fever : Unknown origin 29 case (14.57%) surgical site infection  1 case (0.5%) UTI 1 case (0.5%).

Conclusion: Although prophylactic antibiotics were used in all cases, this study revealed that high incidence of febrile morbidity after laparoscopically assisted vaginal hysterectomy in Srinagarind Hospital.

Keywords: postoperative febrile morbidity; laparoscopically assisted vaginal hysterectomy

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