The Effect of Body Mass Index on the Risk of Postoperative Complications After Myomectomy [ID 2683654

Abstract

INTRODUCTION: We aimed to evaluate the association of body mass index (BMI) and short-term postoperative complications after myomectomy. METHODS: Using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database, we analyzed major and minor complications according to BMI for patients who underwent myomectomy between 2012 and 2020. RESULTS: A total of 29,305 cases were included. Postoperative complications occurred in 11.5% of cases (n=3,374), ranging from 10.2% among underweight patients to 15.9% among patients with obesity class 3 (P<.001). In multivariable regression analysis, overweight patients experienced fewer postoperative complications (adjusted odds ratio [aOR] 95% CI, 0.89 [0.80–0.99]), both minor (aOR 95% CI, 0.89 [0.80–0.99]), and major (aOR 95% CI, 0.75 [0.58–0.98]), compared to patients with normal BMI. Patients with obesity class 1 also experienced fewer major complications compared to normal weight (aOR 95% CI, 0.61 [0.45–0.84]). Patients with obesity class 3 experienced more complications (aOR 95% CI, 1.21 [1.05–1.38]), both minor (aOR 95% CI, 1.17 [1.02–1.34]) and major (aOR 95% CI, 1.17 [1.02–1.35]), compared to the other BMI classes combined. When examining abdominal myomectomies only, compared to normal weight, overweight patients experienced fewer minor complications, and obesity class 1 patients had fewer major complications. Complications did not differ based on BMI when restricting the cohort to minimally invasive or vaginal myomectomies only. CONCLUSION: Class 3 obese patients are at increased odds for experiencing complications after myomectomy, whereas being overweight or slightly obese appears to be protective. These differences based on BMI are largely driven by complications experienced following abdominal, rather than minimally invasive, myomectomy.