Background: The goal of this multicenter study was to examine 30-day outcomes following combined hysterectomy and panniculectomy compared with hysterectomy alone at a national level.
Methods: Female patients who underwent hysterectomy with or without concurrent panniculectomy were identified in the 2005 through 2012 American College of Surgeons National Surgical Quality Improvement Program Participant Use Data Files. Propensity scores were used to match patients who underwent combined surgery to a sample of similar patients who underwent hysterectomy alone.
Results: A total of 24,893 patients who underwent hysterectomy alone and 174 patients who underwent hysterectomy with concurrent panniculectomy were identified. Patients who underwent combined surgery were more often obese (body mass index ≥30 kg/m2), with diabetes mellitus, and cardiovascular/pulmonary comorbidities. Unadjusted outcomes for the total cohort showed that patients who underwent both procedures more often experienced venous thromboembolism (2.9 percent versus 1.0 percent; p = 0.015) and length of stay greater than 3 days (48.3 percent versus 29.2 percent; p < 0.001). In the propensity-matched sample, there were no differences shown in the proportion of patients who experienced wound complications, surgical-site infections, venous thromboembolism, medical complications, or total complications. However, patients who underwent both procedures were twice as likely to experience length of stay greater than 3 days (OR, 2.06; 95 percent CI, 1.28 to 3.31).
Conclusions: Combined hysterectomy and panniculectomy procedures appear to be performed infrequently among American College of Surgeons National Surgical Quality Improvement Program-participating hospitals. After propensity matching, only differences in length of stay were identified.
Clinical question/level of evidence: Therapeutic, III.