Comparison of laparotomy and laparoscopy in hysterectomies for benign uterus diseases

Abstract

Aim: To compare the difference between laparoscopic (L/S) and laparotomic (L/T) hysterectomies and the addition of oophorectomy to surgery by complications, blood transfusion, and changes to hemoglobin (Hb) levels and explore the impacts of diabetes mellitus (DM), smoking, previous abdominal surgery, and body mass index (BMI) on early and late complications. Methods: We recruited 537 patients for this retrospective cross-sectional study. The patients were initially divided into two groups: L/S and L/T and were further divided into subgroups by the addition of oophorectomy. We then compared the groups by early and late complications, changes to Hb levels, and blood transfusion. Moreover, we explored the associations between early and late complications and DM, previous abdominal surgery, and smoking. Results: The findings revealed that 22.7% of hysterectomies were L/S, and 77.3% were L/T. We concluded similar results between main groups and subgroups. Yet, we could not reach significant impacts of BMI, DM, smoking, and abdominal surgery on complications. Even though postoperative blood transfusion was found to be significantly higher in the L/T group than L/S group (L/S: 0.8%, L/T: 5.8%, p=0.022), it did not significantly differ between the subgroups (Group 1: 3.3%, Group 2: 0%, Group 3: 6.5%, Group 4: 5.5%, p= 0.114). Besides, 6.7% of the patients developed complications. We discovered surgical site infection in 3% of the patients, bleeding and hematoma in 1.6%, and urinary tract injury in 0.9%, while there was only one mortality. Conclusion: Overall, we could not conclude a significant difference between L/S and L/T hysterectomies for benign reasons, except by postoperative blood transfusion. Moreover, oophorectomy did not contribute to the risk of surgery-related complications and blood transfusions.