OBJECTIVE This study aimed to assess the relationship between body mass index (BMI) and short-term postoperative complications following myomectomy. METHODS Utilizing data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database spanning the period from 2012 to 2020, we conducted an analysis of major and minor 30-days postoperative complications stratified by BMI among patients who underwent abdominal or laparoscopic (conventional or robotic assisted) myomectomy. Vaginal myomectomy cases were excluded. Complications were stratified according to the Clavien-Dindo classification. RESULTS A total of 27,387 cases were included. Postoperative complications occurred in 11.4% of cases (n=3,131), ranging from 9.4% among underweight patients to 16.1% among patients with obesity class 3 (p<0.001). In multiple regression analysis, patients with obesity class 1 experienced fewer postoperative major complications [aOR 95%CI 0.71 (0.53-0.96)], compared to patients with normal BMI. Conversely, patients with obesity class 2 demonstrated more complications [aOR 95%CI 1.18 (1.03-1.35)] including minor complications [aOR 95%CI 1.17 (1.02-1.34)], and obesity class 3 demonstrated more complications [aOR 95% CI 1.26 (1.08-1.47)] including minor [aOR 95%CI 1.21 (1.03-1.42)] and major [aOR 95%CI 1.41 (1.01-21.99)] complications, compared to patients with normal BMI. Similar outcomes were observed when analyzing abdominal myomectomy exclusively, with disparities much less pronounced when the analysis was confined to laparoscopic myomectomies. CONCLUSION Patients with class 2 and class 3 obesity are at increased odds of experiencing complications following myomectomy, while those with a slightly elevated BMI may experience a protective effect. These BMI-related discrepancies in complication rates predominantly manifest following abdominal myomectomy procedures rather than laparoscopic approach.

中文翻译：

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体重指数对子宫肌瘤切除术后术后并发症风险的影响。


目的 本研究旨在评估体重指数 （BMI） 与子宫肌瘤切除术后短期术后并发症的关系。方法 利用来自 2012 年至 2020 年期间美国外科医师学会国家手术质量改进计划 （NSQIP） 数据库的数据，我们对接受腹部或腹腔镜（传统或机器人辅助）子宫肌瘤切除术的患者按 BMI 分层的术后 30 天主要和次要并发症进行了分析。阴道子宫肌瘤切除术病例被排除在外。根据 Clavien-Dindo 分类对并发症进行分层。结果 共纳入 27,387 例。术后并发症发生率为 11.4% 的病例 （n=3,131），从体重不足患者的 9.4% 到 3 级肥胖患者的 16.1% 不等 （p<0.001）。在多元回归分析中，与 BMI 正常的患者相比，1 级肥胖患者术后主要并发症发生较少 [aOR 95%CI 0.71 （0.53-0.96）]。相反，与 BMI 正常的患者相比，2 级肥胖患者表现出更多的并发症 [aOR 95% CI 1.18 （1.03-1.35）] 包括轻微并发症 [aOR 95%CI 1.17 （1.02-1.34）]，而 3 级肥胖患者表现出更多的并发症 [aOR 95% CI 1.26 （1.08-1.47）]，包括轻微 [aOR 95%CI 1.21 （1.03-1.42）] 和主要 [aOR 95%CI 1.41 （1.01-21.99）] 并发症。当仅分析腹部子宫肌瘤切除术时，观察到类似的结果，当分析仅限于腹腔镜子宫肌瘤切除术时，差异要小得多。结论 2 级和 3 级肥胖患者在子宫肌瘤切除术后出现并发症的几率增加，而 BMI 略有升高的患者可能会出现保护作用。 这些与 BMI 相关的并发症发生率差异主要表现在腹部子宫肌瘤切除术后，而不是腹腔镜手术后。