Association between timing of cervical excision procedure to minimally invasive hysterectomy and surgical complications

Stephanie A. Sullivan, Leslie H. Clark, Allison S. Staley, Arthur Quan Tran, Aaron Winn, Kenneth H. Kim

Research output: Research - peer-reviewArticle

Abstract

Objective To determine if the time interval between excision procedure and definitive minimally invasive surgery (MIS) for cervical cancer impacts 30-day postoperative complications. Methods A retrospective cohort of patients diagnosed with cervical cancer from January 2000 to July 2015 was evaluated. Patients who underwent a cervical excision procedure followed by definitive MIS within 90 days were included. Early definitive surgery was defined as ≤ 6 weeks following excision procedure, while delayed was defined as 6 weeks to 3 months. The primary outcome was 30-day complications. Statistical analysis included descriptive statistics and modified Poission regression. Results Overall, 138 patients met inclusion criteria. Of these, 33% (n = 46) had early definitive surgery and 67% (n = 92) had delayed definitive surgery. Median age was 42 years (range 23–72 years) and median BMI was 28 kg/m2 (range 16–50 kg/m2). Within demographic and surgical factors collected, only smoking status differed between groups with those in the delayed surgery group more likely to be non-smokers than those in the early surgery group (p = 0.04). When adjusting for relevant demographic and surgical factors, patients in the early group were twice as likely to have 30-day complication (aRR 2.6, 95%CI 1.14–5.76, p = 0.02). Evaluating only women who underwent a radical procedure, 30-day complications remained higher in the early surgery group (RR 2.56; 95%CI 1.22–5.38, p = 0.01). Conclusions Performing definitive MIS for cervical cancer within 6 weeks after cervical excision is associated with increased risk for 30-day complications. Providers should consider delaying definitive surgical procedures for at least 6 weeks following excision to reduce surgical complications.

LanguageEnglish (US)
Pages294-298
Number of pages5
JournalGynecologic Oncology
Volume144
Issue number2
DOIs
StatePublished - Feb 1 2017

Fingerprint

Hysterectomy
Minimally Invasive Surgical Procedures
Uterine Cervical Neoplasms
Demography
Smoking

Keywords

  • Cervical cancer
  • CKC
  • Excision
  • Hysterectomy
  • LEEP

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Association between timing of cervical excision procedure to minimally invasive hysterectomy and surgical complications. / Sullivan, Stephanie A.; Clark, Leslie H.; Staley, Allison S.; Tran, Arthur Quan; Winn, Aaron; Kim, Kenneth H.

In: Gynecologic Oncology, Vol. 144, No. 2, 01.02.2017, p. 294-298.

Research output: Research - peer-reviewArticle

Sullivan, Stephanie A. ; Clark, Leslie H. ; Staley, Allison S. ; Tran, Arthur Quan ; Winn, Aaron ; Kim, Kenneth H./ Association between timing of cervical excision procedure to minimally invasive hysterectomy and surgical complications. In: Gynecologic Oncology. 2017 ; Vol. 144, No. 2. pp. 294-298
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abstract = "Objective To determine if the time interval between excision procedure and definitive minimally invasive surgery (MIS) for cervical cancer impacts 30-day postoperative complications. Methods A retrospective cohort of patients diagnosed with cervical cancer from January 2000 to July 2015 was evaluated. Patients who underwent a cervical excision procedure followed by definitive MIS within 90 days were included. Early definitive surgery was defined as ≤ 6 weeks following excision procedure, while delayed was defined as 6 weeks to 3 months. The primary outcome was 30-day complications. Statistical analysis included descriptive statistics and modified Poission regression. Results Overall, 138 patients met inclusion criteria. Of these, 33% (n = 46) had early definitive surgery and 67% (n = 92) had delayed definitive surgery. Median age was 42 years (range 23–72 years) and median BMI was 28 kg/m2 (range 16–50 kg/m2). Within demographic and surgical factors collected, only smoking status differed between groups with those in the delayed surgery group more likely to be non-smokers than those in the early surgery group (p = 0.04). When adjusting for relevant demographic and surgical factors, patients in the early group were twice as likely to have 30-day complication (aRR 2.6, 95%CI 1.14–5.76, p = 0.02). Evaluating only women who underwent a radical procedure, 30-day complications remained higher in the early surgery group (RR 2.56; 95%CI 1.22–5.38, p = 0.01). Conclusions Performing definitive MIS for cervical cancer within 6 weeks after cervical excision is associated with increased risk for 30-day complications. Providers should consider delaying definitive surgical procedures for at least 6 weeks following excision to reduce surgical complications.",
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N2 - Objective To determine if the time interval between excision procedure and definitive minimally invasive surgery (MIS) for cervical cancer impacts 30-day postoperative complications. Methods A retrospective cohort of patients diagnosed with cervical cancer from January 2000 to July 2015 was evaluated. Patients who underwent a cervical excision procedure followed by definitive MIS within 90 days were included. Early definitive surgery was defined as ≤ 6 weeks following excision procedure, while delayed was defined as 6 weeks to 3 months. The primary outcome was 30-day complications. Statistical analysis included descriptive statistics and modified Poission regression. Results Overall, 138 patients met inclusion criteria. Of these, 33% (n = 46) had early definitive surgery and 67% (n = 92) had delayed definitive surgery. Median age was 42 years (range 23–72 years) and median BMI was 28 kg/m2 (range 16–50 kg/m2). Within demographic and surgical factors collected, only smoking status differed between groups with those in the delayed surgery group more likely to be non-smokers than those in the early surgery group (p = 0.04). When adjusting for relevant demographic and surgical factors, patients in the early group were twice as likely to have 30-day complication (aRR 2.6, 95%CI 1.14–5.76, p = 0.02). Evaluating only women who underwent a radical procedure, 30-day complications remained higher in the early surgery group (RR 2.56; 95%CI 1.22–5.38, p = 0.01). Conclusions Performing definitive MIS for cervical cancer within 6 weeks after cervical excision is associated with increased risk for 30-day complications. Providers should consider delaying definitive surgical procedures for at least 6 weeks following excision to reduce surgical complications.

AB - Objective To determine if the time interval between excision procedure and definitive minimally invasive surgery (MIS) for cervical cancer impacts 30-day postoperative complications. Methods A retrospective cohort of patients diagnosed with cervical cancer from January 2000 to July 2015 was evaluated. Patients who underwent a cervical excision procedure followed by definitive MIS within 90 days were included. Early definitive surgery was defined as ≤ 6 weeks following excision procedure, while delayed was defined as 6 weeks to 3 months. The primary outcome was 30-day complications. Statistical analysis included descriptive statistics and modified Poission regression. Results Overall, 138 patients met inclusion criteria. Of these, 33% (n = 46) had early definitive surgery and 67% (n = 92) had delayed definitive surgery. Median age was 42 years (range 23–72 years) and median BMI was 28 kg/m2 (range 16–50 kg/m2). Within demographic and surgical factors collected, only smoking status differed between groups with those in the delayed surgery group more likely to be non-smokers than those in the early surgery group (p = 0.04). When adjusting for relevant demographic and surgical factors, patients in the early group were twice as likely to have 30-day complication (aRR 2.6, 95%CI 1.14–5.76, p = 0.02). Evaluating only women who underwent a radical procedure, 30-day complications remained higher in the early surgery group (RR 2.56; 95%CI 1.22–5.38, p = 0.01). Conclusions Performing definitive MIS for cervical cancer within 6 weeks after cervical excision is associated with increased risk for 30-day complications. Providers should consider delaying definitive surgical procedures for at least 6 weeks following excision to reduce surgical complications.

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