Journal of the Dow University of Health Sciences (Oct 2022)
Safety of Laparoscopic Surgery in Gynecologic Emergencies: Comparative Analysis with and without Previous Abdominopelvic Surgery
Abstract
Objective: To determine the safety of laparoscopic surgery with and without history of previous abdominopelvic surgeries among women undergoing gynecological emergencies in a private tertiary care hospital of Karachi. Methods: This analytical comparative study was conducted at Patel Hospital from Jan 2018 to Jan 2020. The study included all non-pregnant and pregnant women aged 16 years and above diagnosed with acute abdomen pain due to gynecological causes. Patients divided into two groups on the basis of their presence or absence of history of abdominopelvic surgeries. Safety was defined based on risk/frequency of organ injury amount of blood lose, need of per-operative transfusion and surgical time. Post-operatively the safety is measure by duration of hospital stay, post operative pyrexia, and wound infection. Results: Of 92 women, the mean age was 28.6±6.5 years. There were 36 (39.1%) women with previous abdominopelvic surgical history and 56 (60.9%) without previous abdominopelvic surgical history. No significance difference of blood loss (p-value 0.382) and duration of hospital stay (p-value 0.475) were observed in both groups. However, duration of surgery was the only variable which was found significantly different in both groups (p-value 0.018). Among 56 patients with no previous abdominopelvic surgery, per-operative transfusion was found in 14 (25%) and post-operative pyrexia in only 2 (3.6%) patients. Whereas none of the patients in both groups reported wound infection or organ injury. Conclusion: Laparoscopic procedures are safe to use in gynecological emergencies for both diagnostic and therapeutic purposes regardless of presence of history of abdominopelvic surgeries.