Clinical Characteristics Related to Complications in Abdominal Gynecological Surgery
Authors:   Medical Resident in Gynecology and Obstetrics. https://orcid.org/0009-0006-3079-443X, Izamar Lara Cons, , Gabriela Carranza Bustos Lizbeth ,   Gynecology-Obstetrics Hospital, High Specialty Medical Unit, National Medical Center of the West (I.M.S.S.), Guadalajara, Jalisco, Mexico https://orcid.org/0000-0003-1746-1885
Published: February 2025

Background: Gynecological conditions account for a significant number of surgical procedures performed worldwide, with complication rates reported between 0.2-34%. In Mexico, complication rates range from 2.15% to 15.06%. Factors such as age, obesity, comorbidities (hypertension, diabetes), and prolonged surgical time are associated with a higher risk of complications, including postoperative infections.

Objective: To determine the clinical characteristics related to complications in abdominal gynecological surgery.

Materials and Methods: A retrospective, descriptive, cross-sectional, and analytical study was conducted on women undergoing scheduled surgery by the Gynecology service at the Hospital de Ginecoobstetricia UMAE-CMNO IMSS during the period from January 2023 to December 2023. The study aimed to determine the frequency of postoperative complications and their relationship with clinical characteristics. The sample size calculation used the proportion formula and finite population, requiring a minimum sample of 156 patients. However, all gynecological surgeries performed during the study period were included. After obtaining approval from the Local Research Committee in Health 1310, data was collected from the hospital’s surgical productivity registry platform. Surgical data was obtained from both electronic and physical clinical records to identify postoperative complications. The data collection tool was entered into a Microsoft Excel database, and statistical analysis was performed using IBM SPSS (version 30.0).

Results: A total of 392 patients were included in the study. Among them, 78 patients (19.9%) experienced complications. The most common complication was hemorrhage (9.2%), followed by wound dehiscence (3.6%), bladder injury (3.1%), surgical wound infection (2.6%), fever (1.5%), vaginal dome hematoma (1.0%), intestinal injury, and urinary tract infection (both at 0.8%), paralytic ileus (0.3%), along with other complications such as vascular injury and death (0.3%).

When analyzing the groups, it was found that patients in the complication group had a higher Body Mass Index (BMI) compared to those without complications. Additionally, the surgical time, estimated bleeding, and hospital stay days were significantly higher in the complication group. Both groups showed similar characteristics in terms of age, parity, prior abdominal surgeries, comorbid conditions, smoking, ASA risk classification, and preoperative hemoglobin levels.

Conclusions: The frequency of postoperative complications in this study aligns with findings reported in most international studies, with hemorrhage being the most common complication. BMI was significantly associated with a higher risk of complications, including bleeding, need for transfusions, and prolonged surgical times.