Comparison of Total and Supracervical Laparoscopic Hysterectomy for Benign Disease in a Collective of 200 Patients

Abstract

Objective: The purpose of this study was to compare total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LASH) for benign disease, in terms of pre-, intra-, and postoperative findings and complications as well as necessary concomitant operative procedures. Design: This study was a retrospective review of 200 women who underwent LASH or TLH between September 2009 and April 2011. Materials and Methods: Statistical analysis and comparison of medical records were performed. Main outcome measures were patient characteristics, operating time, blood loss, uterine weight, concomitant procedures, length of stay, and intra- and postoperative complications. Results: TLH was performed in 108 cases, and 92 patients underwent LASH. The mean follow-up times were 12.5±5.4 months for TLH and 13.4±5.7 months for LASH. Suspected benign tumors of the uterus were the most frequent indication for both TLH and LASH (78% of all cases). The operating time for TLH was significantly longer than the time needed for LASH (p=0.004). The blood losses did not significantly differ. Concomitant operative procedures were necessary in 73% of all cases, mostly for the lysis of adhesions and the treatment of ovarian pathologies. Laparoconversion rate was 0.5%. The rate of wound healing problems was significantly higher in the group of patients who underwent TLH than in the group who underwent LASH (p=0.027). The groups did not differ in the rate of stationary readmission and repeat operation (p=0.531). Conclusions: Both procedures can be performed with a minimal rate of intra- and postoperative complications, even though removal of the cervix is associated with a higher rate of postoperative vaginal cuff wound healing problems. (J GYNECOL SURG 28:333)