Complications of abdominal hysterectomy for benign gynecological diseases. Experience in Mexico

Background: Abdominal hysterectomy is the most common gynecological surgical procedure worldwide. The selection of the technique should consider the characteristics of the uterus and surrounding organs, concurrent procedures, surgical team experience, hospital technology and resources, whether the surgery is urgent or elective, estimated recovery time, quality of life, scar cosmeticity, and patient preference once the information has been provided. Complications are inherent to the technique and to factors associated with patient morbidities, the complexity of the benign gynecological pathology, and the skills of the surgical team. The most common complications include blood loss (intraoperative hemorrhage, postoperative bleeding), infections, genitourinary and gastrointestinal tract injuries, nerve injury, vaginal cuff dehiscence, deep vein thrombosis and pulmonary embolism. In five studies conducted in Mexico from 2014 to 2025 that included a total of 2,162 patients, the mean complication rate was 16.50%. Blood loss was the main cause, as were international investigations. Recommendations to reduce the possibility of complications include more rigorous criteria and the use of validated predictive models for patient selection, recommending abdominal hysterectomy versus minimally invasive surgery, training the surgical team using simulators, advising on each surgery, involving surgeons experienced in vascular procedures, evaluating with learning curves, periodically reviewing surgical results, publishing data, and providing feedback. Keywords: Abdominal hysterectomy; Hysterectomy; Complications of hysterectomy; Benign gynecological pathology; Elective uterine surgery.