الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Overweight and obesity are considered nowadays as a global pandemic with drastic effects on health issues. Egypt is considered one of the top ten countries with high obesity prevalence worldwide.
Body fat can be measured in several ways, with each body fat assessment method having its pros and cons. The most basic method and the most common is the body mass index (BMI) and is defined as the body weight divided by the square of the body height. WHO defines different categories of BMI as follows :Underweight is a BMI less than 18, while normal as 18.5 to 24.9, overweight is a BMI greater than or equal to 25 and obesity is a BMI greater than or equal to 30 and is subdivided into moderate ,severe and morbid obesity.
A high BMI is a risk factor for a number of diseases leading to hysterectomy such as fibroids and abnormal uterine bleeding and hysterectomy seems to be the most common gynecologic surgery in the world, with uterine fibroids being the commonest benign gynecological tumor.
There are several surgical routes (abdominal, vaginal and laparoscopic) for the gynecological procedures, where BMI may be a factor that could affect the route of surgery.
Complications of gynecological surgery (especially) hysterectomy vary based on route of surgery and surgical technique. According to ACOG 2013, the most common complications of hysterectomy can be categorized as infectious, venous thromboembolic, genitourinary (GU) and gastrointestinal (GI) tract injury and bleeding.
Wound complications, surgical site infections, and venous thromboembolism remain a major source of morbidity for obese patients undergoing abdominal surgery. As the BMI increases for women undergoing abdominal hysterectomy, so does the risk of surgical site infections and wound complication.
Mortality and morbidity in the obese patients without metabolic complications undergoing general surgery has been shown to be lower than that of normal weight patients, this is called the obesity paradox, unlike obese patients with metabolic syndrome and underweight patients are associated with more complications.
Gynecological surgeons should consider laparoscopic and vaginal routes instead of abdominal route for the obese patients, to avoid obesity related complications.
So the aim of the present study was to evaluate the effect of different BMI groups with associated comorbidities on occurrence of perioperative complications following laparotomy for gynecologic cause.
This was a cross sectional study survey conducted at El Shatby University Maternity Hospital and involved 565 female patients who underwent laparotomy for gynecologic cause and met the inclusion criteria.