The effect of obesity on total abdominal hysterectomy

To compare perioperative outcomes of total abdominal hysterectomy (TAH) between obese and nonobese women.

The medical charts of all women who underwent TAH for benign gynecological conditions at Temple University Hospital between 1997 and 2002 were reviewed. We excluded those who had concomitant surgery except for adnexal removal. The rates of perioperative indices were compared between obese (body mass index [BMI] ≥ 30 kg/m²) and nonobese women; p < 0.05 was considered significant.

Of 357 women, 172 (48.2%) were obese, and 185 (51.8%) were not. Among the baseline characteristics, only race was statistically different between the groups. There were more African American women among the obese women (82.5% vs. 70%, p < 0.05). Postoperative complications, including urinary tract injury, were not significantly increased in the obese group. On the contrary, nonobese women had a significantly higher incidence of ileus (13.5% vs. 6.4%, p < 0.05). Although operative time was significantly prolonged for obese women, obesity did not increase the length of hospitalization, transfusion rate, and perioperative hemoglobin change. All these results remained the same even after controlling for race.

Contrary to the general opinion, obesity does not significantly affect the perioperative outcomes for TAH performed for benign gynecological causes.