Our objective was to examine the correlation between age and postoperative complications following laparoscopic hysterectomy for endometriosis.

Design:

A cohort study using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP).

Setting:

N/A

Patients or Participants:

Patients who underwent laparoscopic (including robotic-assisted laparoscopy) hysterectomy for endometriosis between 2012 and 2020.

Interventions:

Laparoscopic hysterectomy for a primary indication of endometriosis.

Measurements and Main Results:
During the study period, 6,768 patients underwent hysterectomy for endometriosis, with 624 (9.2%) under 30 years old, 2,790 (41.2%) between 30 and 40 years old, 2,863 (42.3%) between 40 and 50 years old, and 491 (7.2%) aged 50 or older.

Thirty-day postoperative complications occurred in 8.3% of cases (n=561), with major complications accounting for 3.6% (n=241). Multivariable regression analysis, adjusting for race/ethnicity, comorbidities, concomitant procedures performed, and uterine size, revealed a significantly lower rate of major complications in patients aged 50 or older compared to patients under 30 years old [adjusted odds ratio (aOR), 95% confidence interval (CI) 0.4 (0.19-0.84)]. The rate of any complications was also noted to be lower, [aOR 95% CI 0.56 (95% CI 0.34-0.92)]. Further analysis, relative to the median age of 39 years, underscored a significantly lower risk of major complications in patients older than 39 compared to their younger counterparts, [aOR 95% CI 0.69 (95% CI 0.53-0.90)]. There was no significant difference in the rate of minor postoperative complications between age categories.

Conclusion:
Among patients undergoing hysterectomy for endometriosis, women aged 39 or older exhibited a lower risk of major postoperative complications compared to patients under age 39. Further investigation is warranted to elucidate the underlying reasons for this observation. Possible factors to explore include the severity of the disease necessitating earlier hysterectomy among younger patients or the interplay between disease state, age, and hormonal status.