Achievement of Self-Reported Goals from a Randomized Trial of Laparoscopic Versus Abdominal Hysterectomy for Benign Indications

Abstract

<h3>Study Objective</h3> To assess differences in patient-reported goal achievement in participants undergoing laparoscopic and abdominal hysterectomy for benign indications. <h3>Design</h3> A prospective randomized controlled trial. <h3>Setting</h3> Enrollment was performed at a single, tertiary care academic institution. <h3>Patients or Participants</h3> Participants over 18 years old undergoing hysterectomy for benign indications were eligible for enrollment. <h3>Interventions</h3> Laparoscopic hysterectomy versus abdominal hysterectomy. <h3>Measurements and Main Results</h3> 88 participants were enrolled and included in the final analysis. Each participant listed three self-generated goals hoped to be achieved by undergoing surgery, and rated goal achievement from 1-10, with 1 (goal not achieved) and >8 (goal achieved). Goal achievement at 6 weeks, 6 and 12 months postoperatively was assessed. The length of time to goal achievement (in days) was recorded in both groups. The most commonly stated goals for undergoing hysterectomy were resolution of bleeding, improvement in pain and improved quality of life. There were no significant differences in goal achievement scores at any time point following surgery between groups for any of the three goals. There were no differences in the length of time in goal achievement between laparoscopic or abdominal hysterectomy in any of the three goals. Regardless of route, over 70% of subjects in both groups achieved the top 3 goals at 12 months, and most achieved goals by 6 weeks postoperatively. <h3>Conclusion</h3> No differences were noted in goal achievement, nor time to goal achievement in the two groups. Overall, patients experience symptom relief and very high rates of surgical goal achievement following hysterectomy regardless of the route of surgery. Further studies are needed to investigate the impact of surgical route on patient-centered goals.