Operative Complications Diagnosed by CT Scan in Minimally Invasive Hysterectomy Patients [24E]

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INTRODUCTION: The indications for CT scan to evaluate complications of minimally invasive surgery have not been well established. The objective of this study was to identify patient characteristics and clinical findings that correlated with postoperative complications diagnosed on CT scan. METHODS: A retrospective cohort study was conducted with patients who underwent laparoscopic or robotic hysterectomy, from 2011 to 2013, and had a CT scan to evaluate postoperative complications. Patient characteristics and clinical findings were analyzed for association with 1) a CT being ordered 2) abnormal CT findings. RESULTS: 784 patients underwent minimally invasive hysterectomy. 74 (9.4%) had a CT scan. Patients who underwent CT scan were demographically similar to those who did not except for a lower BMI (P=.025) and a trend toward younger age (P=.543). Chronic pain and history of prior abdominal surgery were associated with the CT scan group. There were no significant differences between patients with abnormal versus normal CT scan. In the CT scan group, subgroup analysis of CT findings (primary abnormal, incidental abnormal, normal) demonstrated a significant difference in WBC count (P=.017). CONCLUSION: Patients with smaller BMI, chronic pain, and history of abdominal surgery were more likely to undergo CT scan for workup of postoperative complication, but not more likely to have abnormalities on CT scan. There were no associations between patient characteristics or indications for CT and abnormal CTs. A larger study with more CT scans and abnormal findings may show associations not found in this study.

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