Abstract
This study aimed to assess intraoperative complication rates and risk factors in patients who underwent surgery for tubo-ovarian abscess. A retrospective review of the medical records of 170 patients who underwent tubo-ovarian abscess surgery between January 2014 and December 2023 was conducted. Four patients were excluded due to a histopathologic diagnosis of cancer, and 166 patients were included in the final analysis. Intraoperative complications were observed in 10 (6.0%) patients, including 8 (4.8%) and 2 (1.2%) patients with bowel and bladder injuries, respectively. The included patients were categorized into complication-positive (n = 10, 6.0%) and complication-negative (n = 156, 94.0%) groups, with between groups comparisons based on demographic, clinical, and surgical characteristics. The complication-positive group had significantly higher mean age and serum c-reactive protein (CRP) levels than the complication-negative group (46.6 ± 7.4 years vs 40.6 ± 8.5 years; P = .03, and 199.2 ± 89.4 mg/L vs 112.2 ± 84.2 mg/L; P ≤ .01, respectively). Extensive surgery, such as hysterectomy with bilateral adnexectomy, was more commonly performed in the complication-positive group than in the complication-negative group (8/10 [80.0%] vs 43/156 [27.5%], P < .01). Receiver operating characteristic curve analysis identified a serum CRP level of 186.5 mg/L as the optimal cutoff for predicting intraoperative complications. Binary logistic regression analysis showed that elevated serum CRP levels (≥186.5 mg/L) (odds ratio: 7.9; P < .01) and extensive surgery (odds ratio: 11.0, P = .01) were independently associated with intraoperative complications. Our findings indicate that elevated serum CRP levels and extensive surgery are associated with increased intraoperative complication risks, which may have important implications in clinical practice, potentially informing preoperative assessments, and surgical planning. This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology statement.