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The following is a summary of “Short-term outcomes of minimally invasive total vs supracervical hysterectomy for uterine fibroids: a National Surgical Quality Improvement Program study,” published in the April 2025 issue of American Journal of Obstetrics & Gynecology by Meyer et al. 

Uterine fibroids had been the primary reason for benign hysterectomy in the United States, yet information regarding the relationship between the type of hysterectomy and patient outcomes for this condition had been absent.  

Researchers conducted a retrospective study to compare the rate and odds of short-term (30-day) postoperative complications between individuals who underwent minimally invasive total laparoscopic hysterectomy and those who had laparoscopic supracervical hysterectomy for uterine fibroids.  

They collected data from the American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2020. Characteristics of individuals who underwent total laparoscopic hysterectomy and laparoscopic supracervical hysterectomy for uterine fibroids were analyzed. Risk factors for 30-day postoperative complications, defined by the Clavien-Dindo classification, were identified. Multivariate regression analysis accounted for age, body mass index, race, comorbidities, American Society of Anesthesiologists classification, uterine weight, and concomitant procedures to determine adjusted odds of complications. Co-primary outcomes included the risk of any postoperative complication, and the risk of major complications based on surgical type.  

The results showed that 44,413 individuals underwent minimally invasive total laparoscopic hysterectomy, while 6,383 underwent laparoscopic supracervical hysterectomy. Operative time was shorter in the total laparoscopic hysterectomy group compared to the laparoscopic supracervical hysterectomy group (143.0 vs 150.6 minutes, P < .001). Uterine weight exceeding 250 g was less common in the total laparoscopic hysterectomy group than in the laparoscopic supracervical hysterectomy group (39.4% vs 45.1%, P < .001). The total laparoscopic hysterectomy group had higher rates of any complications (6.6% vs 5.3%, P < .001) and major complications (2.7% vs 1.6%, P < .001), while minor complication rates were similar between groups (4.4% vs 4.1%, P = .309). In multivariate regression analysis, laparoscopic supracervical hysterectomy was linked to a lower risk of any complications (adjusted odds ratio, 0.79; 95% confidence interval, 0.70–0.88) and major complications (adjusted odds ratio, 0.55; 95% confidence interval, 0.44–0.69) compared to total laparoscopic hysterectomy.  

Investigators concluded that laparoscopic supracervical hysterectomy was linked to a lower risk of short-term postoperative complications in individuals with uterine fibroids than total laparoscopic hysterectomy. 

Source: ajog.org/article/S0002-9378(24)01054-8/abstract