Comparison of the Clinical Characteristics between Total Laparoscopic Hysterectomy (TLH) and Laparoscopy-Assisted Vaginal Hysterectomy (LAVH)

Abstract

Study Objective: To help selecting better surgical procedure by comparing clinical characteristics between total laparoscopic hysterectomy (TLH) and laparoscopy-assisted vaginal hysterectomy (LAVH). Design: Retrospective study. Setting: From July to December, 2006, total 165 cases of patients were performed hysterectomy (TLH 66cases, LAVH 99cases) at Gachon university of medicine and science Gil Medical Center. Patients: The indications of hysterectomy were uterine myoma, adenomyosis, carcinoma in situ, endometrial hyperplasia, ovarian tumor, and dysfunctional uterine bleeding. Intervention: All patients received hysterectomy including TLH and LAVH. We analyzed these cases about age, body mass index, parity, previous operation history, operation indication, operation outcome and complication. Measurements and Main Results: There were no significant differences in terms of patient's age, parity and previous operation history between the two groups. The body mass index was significantly higher in TLH group(p=0.017). The main indications were myoma and adenomyosis. There were no significant differences in uterine weight, blood loss and hemoglobin change between the two groups. The mean operation time was significantly longer in TLH group(p=0.001) and the length of hospital stay was shorter in TLH group(p=0.007). There were 14 cases(8.5%) of complications in total 165 cases. The major complications such as urinary tract injury and urinary fistula were 2 cases for TLH and 3cases for LAVH. Conclusion: LAVH has the merit of short operation time, compared with TLH, but has no significant differences in other clinical variables.