Clinical characteristic and risk factors for post-operative complications in women undergoing laparoscopy myomectomy

Objective: To assess clinical characteristic and risk factors for post-operative complications in women undergoing laparoscopic myomectomy using the Clavien-Dindo classification system. Methods: A retrospective cohort study was conducted at Soroka University Medical Center, Beer Sheva, Israel, between 2010 and 2020, including women who underwent laparoscopic myomectomy. Postoperative adverse events were classified using the Clavien-Dindo system. The study population was divided into two groups: those with complications (Clavien-Dindo classification ≥ 1) and those without complications (Clavien-Dindo classification = 0). Risk factors were compared between the groups and analyzed for statistical significance using univariate and multivariate logistic regression. Results: A total of 111 women who underwent laparoscopic myomectomy were included. Of these, 26 experienced complications (study group) and 85 did not (comparison group); all complications were minor. Women in the study group had a higher incidence of pre-operative symptoms (76.9 % vs. 55.3 %). Additionally, the duration of surgery was significantly longer in the study group (137 min vs. 97 min, p < 0.01), and estimated blood loss was higher, with more frequent use of anti-adhesive agents. There was no significant difference in preoperative anemia between the groups. Estimated blood loss > 100 mL was found to be independently associated with complications (aOR 4.4, 95 % CI 1.5–12.5). Conclusion: Laparoscopic myomectomy is a safe and effective surgical option for women, with a low rate of minor complications. Although longer surgeries and increased blood loss were associated with complications, the overall risk remains minimal. Proper identification of risk factors such as pre-operative symptoms and intraoperative blood loss can help optimize patient outcomes. Future research should further explore the relationship between anemia and surgical outcomes, as no significant differences in anemia were observed in this study.