Laparoscopic hysterectomy versus total abdominal hysterectomy: a retrospective study at a tertiary hospital

Mahmoud Elmorsi Aboulfotouh,Fouad Chaalan,Abdelbaset Fakhry Mohammed

doi:10.1186/s10397-020-01068-1

Mahmoud Elmorsi Aboulfotouh, Fouad Chaalan + Show 1 more

Open Access

https://doi.org/10.1186/s10397-020-01068-1

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Journal: Gynecological Surgery	Publication Date: Apr 10, 2020
Citations: 4	License type: open-access

Affiliation: Hamad Medical Corporation, Minia University

Abstract

ObjectiveTo compare laparoscopic hysterectomy (LH) with total abdominal hysterectomy (TAH) regarding different outcome measures at our tertiary hospital.Study designThis retrospective comparative cross-sectional study was conducted at the Department of Obstetrics and Gynecology Department, Women’s Hospital, Hamad Medical Corporation, Doha, Qatar. It included 44 patients who had LH (group 1) and 95 patients who had TAH (group 2) during the period from January 2009 through June 2014.ResultsThree patients were converted from LH to TAH and were excluded from the final analysis. The size of the uterus was smaller in the LH group than the TAH group (7.38 ± 1.92 vs 10.25 ± 3.84 cm, respectively; p < 0.0005). The operative time was shorter in TAH than in LH (2.22 ± 0.93 vs 2.43 ± 0.94, respectively; p = NS). The blood loss was less in the LH group than the TAH group (258.54 ± 65.26 vs 370.32 ± 74.8, respectively; p = NS). There were no significant differences between both groups regarding rates intraoperative and early postoperative complications; however, late postoperative complications were significantly higher in the TAH group (p < 0.05). The length of hospital stay was shorter with LH than TAH (3.63 ± 1.28 vs 5.22 ± 4 days, respectively; p < 0.001)ConclusionLH compares to TAH in terms of duration of surgery, rates of intraoperative and early postoperative complications, and the need for blood transfusion. However, it has significantly less rate of late postoperative complications and length of hospital stay.

Highlights

Over 430,000 hysterectomies were performed in the USA in 2010, making it the most common gynecological surgical operation
Most studies comparing abdominal and vaginal routes of hysterectomy have concluded that the vaginal approach should be the preferred route as it is associated with less complication rates, shorter hospital stay, and lower cost compared to the abdominal route [2,3,4]
3 out of 44 cases of laparoscopic hysterectomy (LH) were converted to total abdominal hysterectomy (TAH) due to severe adhesions from prior surgeries, and they were excluded from the final analysis

Summary

Introduction

Over 430,000 hysterectomies were performed in the USA in 2010, making it the most common gynecological surgical operation. Between 1998 and 2010, the distribution of the surgical approach was 65% abdominal, 20% vaginal, 13% laparoscopic, 0.9% robotic, and 1.2% had a radical hysterectomy. Most studies comparing abdominal and vaginal routes of hysterectomy have concluded that the vaginal approach should be the preferred route as it is associated with less complication rates, shorter hospital stay, and lower cost compared to the abdominal route [2,3,4]. A statement from the American College of Obstetricians and Gynecologists (ACOG) advises surgeons to use a vaginal approach whenever possible, and for patients in whom vaginal hysterectomy is not feasible or indicated, laparoscopic hysterectomy should be performed over open abdominal hysterectomy. The aim of this study was to compare laparoscopic hysterectomy (LH) with total abdominal hysterectomy (TAH) regarding different outcome measures at our tertiary hospital

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