Analysis of influencing factors and construction of a prediction model for surgical complications in transumbilical single-Port Laparoscopic and conventional laparoscopic total hysterectomy
REN Xiao-yu
FENG Jian-min
YANG Han-lin
ZHU Yan
GONG-Yan
TIAN Wei-jie
ZI Dan
Abstract：Objective To investigate the influencing factors of surgical complications in patients undergoing transumbilical single-port laparoscopic total hysterectomy and traditional laparoscopic total hysterectomy and to construct a prediction model.Methods The clinical data of patients undergoing transumbilical single-port or traditional laparoscopic total hysterectomy for benign diseases at Guizhou Provincial People's Hospital from September 2021 to December 2024 were retrospectively collected.The data were divided into a training set(n=409)and a validation set(n=219).LASSO-logistic regression,full-variable logistic regression,and stepwise logistic regression models were applied to screen for influencing factors in the training set.Model performance was evaluated in multiple dimensions using the area under the receiver operating characteristic curve(AUC),Akaike information criterion(AIC)/Bayesian information criterion(BIC),net reclassification index(NRI)/integrated discrimination improvement index(IDI),and a nomogram was developed.The validation set was used to assess its discrimination,calibration,and clinical applicability.Results Moderate to severe preoperative anemia,history of cesarean delivery,hypertension,and uterine size＞12 gestational weeks were identified as independent risk factors.The LASSO-logistic regression model demonstrated optimal predictive performance[AUC=0.792(95％CI 0.736-0.849);AIC=341.059;BIC=374.115;NRI＞0;IDI＞0].Validation yielded an AUC of 0.785(95％CI 0.700-0.870).Calibration curves showed good consistency between predicted and observed risks.Decision curve analysis confirmed clinical net benefit at risk thresholds＞0.06(training set:0.07-0.98;validation set:0.06-0.86).Conclusions Preoperative anemia,history of cesarean section,hypertension,and uterine size are identified as influencing factors for complications in laparoscopic total hysterectomy.The LASSO-logistic regression model demonstrates certain clinical prediction value.
Keywords：hysterectomytransumbilical single-port laparoscopysurgical complicationsprediction model
Publication Date：2025-07-02
Online Publishing Date：2025-08-19(First online date of this platform, not the publication date of the document)
Pages：5( 755-759 )