Complications in gynecological surgeries in Ukraine: results a multicenter study

. Aim: To analyze the complications during gynecologic surgery procedures and identify possible risk factors associated with this type of surgery in Ukraine.

Materials and Methods: We conducted a multicenter, retrospective cohort study in tertiary care hospitals from 12 regions of Ukraine from January, 2021, to December, 2023. The study included women who underwent gynecologic surgery at these hospitals. Postoperative complications are defined by Clavien-Dindo classification.

Results: A total of 13,937 women were included in our study. The overall prevalence of 30-day complications was 13.9%. The most frequently postoperative complication types were surgical site infections, hemorrhage, urinary tract infection, bowel injury, urinary tract injury, and bladder injury. Age 60 years or older (adjusted odds ratio (aOR 1.81), BMI ≥30 kg/m2 (aOR 1.78), diabetes mellitus (aOR 1.45), procedures for gynecologic cancer (aOR 2.58), prior pelvic surgery (aOR 1.61), emergency procedure (aOR 1.83), ASA-physical status class 5 vs. 1 or 2 (aOR 4.31), operative time greater than 3 hours vs. less than 1 hour (aOR 2.92), wound class 4 vs. 1 (aOR 4.28), and open abdominal approach for surgery vs. laparoscopic procedure (aOR 2.65) were significantly associated with postoperative complications.

Conclusions: This study found a high prevalence of complications rate in gynecological surgery varied widely depending on the approach and type of procedure. Risk factors for complications are age, obesity, diabetes, procedures for gynecologic cancer, prior pelvic surgery, emergency procedure, open abdominal surgery, ASA-physical status, duration of surgery, and wound class.