9660 Risk Factors for Major Complications Following Minimally Invasive Surgeries for Endometriosis in the United States

To study the rate and risk factors for short-term post-operative complications of patients undergoing minimally invasive surgery for endometriosis in the United States. Retrospective cohort study. American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2012-2020. Patients with endometriosis diagnosis. Laparoscopic surgery for endometriosis. We compared women with and without 30-day post-operative major complications, defined according to the Clavien-Dindo classification. 28,697 women underwent minimally invasive surgery during the study period, of which 2.6% had major post-operative complications. Organ space surgical site infection and reoperation were the most common complications (47.0% and 39.8%, respectively). In multivariable regression analysis, African American race [aOR 95%CI 1.61 (1.29-2.01), p<0.001], hypertension [aOR 95%CI 1.23 (1.02-1.50), p=0.035], bleeding disorders [aOR 95%CI 1.96 (1.03-3.73), p=0.042], bowel procedures [aOR 95%CI 2.03 (1.61-2.56), p<0.001] and hysterectomy [aOR 95%CI 2.12 (1.74-2.57), p<0.001] were independently associated with increased risk of major complications. In a subanalysis of laparoscopies without bowel procedures, the rate of major complications was 2.5%. In multivariable regression analysis, African American race [aOR 95% CI 1.57 (1.22-2.01), p<0.001], bleeding disorders [aOR 95% CI 2.06 (1.05-4.08), p=0.037] and hysterectomy [aOR 95% CI 1.95 2.76 (2.16-3.53), p<0.001] were associated with increased major complication risk. Bowel procedures were performed in 2,041 cases, with a major complication rate of 4.3%. In multivariable regression analysis, African American race [aOR 95%CI 1.76 (1.02-3.06), p=0.043], immunosuppressive therapy [aOR 95%CI 3.04 (1.15-8.00), p=0.025] and colectomy [aOR 95%CI 1.96 (1.26-3.06), p=0.003] were associated with increased major complication risk. Among women undergoing minimally invasive surgery for endometriosis, African American race, hypertension, bleeding disorders and bowel surgery or hysterectomy are risk factors for major complications. African American race is a risk factor for major complications among women undergoing surgeries with and without bowel procedures.