Trends in operative time and outcomes in minimally invasive hysterectomy from 2008 to 2018

BackgroundThere is a national shift toward laparoscopic hysterectomy as the predominant form of minimally invasive hysterectomy. Previous research suggests that vaginal associated with lower operative time and improved outcomes; however, this has not been validated in modern cohort women.ObjectiveThis analysis aims to evaluate whether total remains times fewer postoperative complications than or laparoscopic-assisted hysterectomy, given recent shifts clinical practice patterns training experience.Study DesignA secondary National Surgical Quality Improvement Program database was performed. Three primary outcomes were defined for analysis: time, rate major complications, minor complications. Secondary included changes route surgery over time. Descriptive analyses performed all interest. Operative compared each 3 forms hysterectomy: Bivariate using variance, Kruskal-Wallis, Pearson chi-square, Fisher exact tests where appropriate. Multivariable ordinary least squares logistic regression used assess overall differences trends controlling sociodemographic factors medical comorbidities. Sensitivity propensity score–matched created balance groups across time.ResultsA 161,626 women met criteria inclusion. Rates dropped from 51% 13% between 2008 2018, whereas rates increased 12% 68% (P<.001). In multivariable analyses, odds (adjusted ratio [95% confidence interval]: 0.813 [0.750–0.881] 0.873 [0.797–0.957], respectively) 0.723 [0.676–0.772] 0.896 [0.832–0.964], Temporal show an increase decreases 11-year period (P<.001), although continues have shortest median overall. No temporal observed complications.ConclusionThis highlights Alongside change pattern, study also brings light resultant complication surgical approach, despite longer times. There women. This experience. A