Impact of Diabetes Mellitus on Postoperative Complications Following Laparoscopic Hysterectomy for Benign Indications.

ABSTRACT

BACKGROUND: Current research pertaining to minimally invasive gynecologic surgical outcomes in the context of diabetes mellitus (DM) is limited. This study seeks to evaluate the association between DM and postoperative complications following laparoscopic hysterectomy for benign indications. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was utilized. We identified laparoscopic hysterectomies completed for benign indications from 2007 to 2016 using current procedural terminology codes. Complications were evaluated by DM status non-insulin-dependent DM (NIDDM), insulin-dependent DM (IDDM), and non-DM. Postoperative complications were evaluated utilizing univariate and multivariate analyses. RESULTS: We identified 56,640 laparoscopic hysterectomies. Though both the IDDM and NIDDM cohorts had an increased incidence of postoperative complications compared to the non-diabetes cohort. The IDDM group had the highest incidence of all 3 cohorts. Compared to non-DM, the IDDM group had higher odds of reintubation (OR 4.23; 95% CI 1.59-11.19), urinary tract infection (OR 1.45; 95% CI 1.022-2.069), and extended length of stay (OR 1.75; 95% CI 1.36-2.26). CONCLUSION: Both NIDDM and IDDM were independent risk factors for postoperative complications after laparoscopic hysterectomy. However, the IDDM cohort had the highest odds of complications. Diabetic patients should be carefully counseled regarding their elevated risk of perioperative complications.