Operation risks Flashcards
Hysterectomy at CS
7-8 per 1000
New: 1.5 per 1000
Need for further surgery after CS
5 in 1000
ICU admission post CS
9 in 1000
VTE post CS
4-16 per 10,000
Bladder injury at CS
1 in 1000
Ureteric injury at CS
3 in 10,000
Death after CS
1 in 12,000
New: 1 in 4200
Persistent wound and abdominal discomfort in the first few months after CS
9 in 100
Readmission to hospital post CS
5%
Haemorrhage at CS
Needing transfusion
5 in 1000
1-2%
Infection post CS
6%
Risk of uterine rupture in subsequent pregnancies post CS
2-7 in 1000
Blood product shelf lives
- whole blood
- RBCs
- FFP
- Plts
- whole blood = 21-35 days
- RBC = 42 days
- FFP = 1 year
- Plts = 5 days
At what INR can you proceed with surgery
<=1.4
Laparoscopy risk of bowel injury
0.4 in 1000 if closed entry
0.6 in 1000 if open entry
Laparoscopy risk of major vessel injury
0.2 in 1000
Risk of umbilical adhesions post previous:
- midline laparotomy
- low transverse incision
- 50%
- 23%
Laparoscopy risk of death
1 in 70,000
Steps of hysterectomy
- Enter abdomen
- Rounds
- Broad ligament
- IPs (or utero-ovarian ligaments)
- Bladder mobilisation
- Uterine vessels
- Cardinal ligaments
- Uterosacrals
- Vault
Abdominal hysterectomy overall risk of serious complications
4%
Abdominal hysterectomy risk of bladder/ureter damage
7 in 1000
Abdominal hysterectomy risk of bowel injury
4 in 10,000
TAH Haemorrhage requiring blood transfusion
23 women in every 1000 (common)
2.3%
TAH risk of return to theatre because of bleeding/wound dehiscence
7 in 1000 (uncommon)
