Abstract
Study Objective To compare surgical outcomes between total laparoscopic (TLH) and total vaginal (TVH) hysterectomy with uterine weight (UW) ≥250 grams Design Retrospective cohort study using 1:2 propensity score (PS) matching. PS was calculated using preoperative characteristics and UW. Pairwise analysis was performed using Wilcoxon rank-sum and Fisher's exact tests as appropriate. Multivariable logistic regression was performed to identify the independent impact of TVH on surgical outcomes. Setting American College of Surgeons National Quality Improvement Project Hysterectomy Specific Database. Patients or Participants Women undergoing benign hysterectomy for UW ≥250g. Interventions TLH or TVH. Measurements and Main Results There were 1,870 TVH that met all criteria for inclusion and matched to 3,740 TLH. There were no differences in preoperative demographics and comorbidities. UW was similar for both groups 376 g (IQR: 293-501) for TVH and 384 g (IQR 302-515) for TLH, p=0.07. TVH was completed in less time than TLH, 77 (IQR: 56-111) versus 122 (IQR: 91-164) minutes, p Conclusion In patients with similar preoperative characteristics and uterine weight TVH is not associated with an increased risk of major surgical morbidity or other adverse surgical outcomes.
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