The Timing Of Hysterectomy After Conization

Objective:Explore the influence of different time interval between conization and subsequent hysterectomy, to chose the appropriate timing for operation.Methods:Retrospective analysis of361cases which about patients choice hysterectomy for further treatment after conization in Women’s hospital school of medicine Zhejiang University from January2009to October2014. Study and compare the influences of different time interval on the perioperative information about the subsequent operation.Results:Among different groups, there was no significant difference in general characteristics of patients (age、gravidity, parity, menstruation)or perioperation period variations(operation time、the amount of bleeding、the change of hemoglobin)(p>0.05), but had statistical difference in the days of using antibiotics and of posthysterectomy hospital stay (p<0.05).Postoperative morbidity appeared in34.1%of the patients, and other postoperation complications occurred in4.7%. Among the post operation pathological results,63.9%had no obvious lesions,6.5%was found to have CIN,27%was found to have cancer cells. Risk factor for antibiotic using days after operation was the operation range. Risk factor of hospital stay was operation range, and protective factor was the conization type. Risk factor of postoperative morbidity was age, the protective factor was menstruation and time interval. Protective factor of postoperation complications was time interval. Use ROC curve to predict postoperation complications based on time interval, the area under curve was0.705. It had medium accuracy with statistical significance (P<0.05). When time interval chose41.5days, got largest Youden index0.321, and the sensitivity was0.674, specificity was0.647.Conclusion:Time interval between conization and hysterectomy has effect on postoperative morbidity and postoperation complication. When the time interval is over41.5days or6weeks can be the best critical value to predict none postoperation complication.