No Difference in Length of Hospital Stay Between Laparoscopic and Abdominal Supravaginal Hysterectomy???A Preliminary Study

Abstract

Numerous trials have concluded that laparoscopic hysterectomy, compared with total abdominal hysterectomy, causes less postoperative pain and shortens the hospital stay. Many view this approach as being more cost-effective, but a recent large, randomized trial demonstrated more major complications after the laparoscopic procedure. The present study compared the length of time in the hospital, time to convalescence, and long-term patient satisfaction in 47 consecutive women who were to have supravaginal hysterectomy. Twenty-three of them were randomized to undergo abdominal supravaginal hysterectomy (ASH) and 24 laparoscopic supravaginal hysterectomy (LSH). Pre- and postoperative procedures were comparable in the 2 groups, and there were no significant differences in demographic features or physical characteristics. The postoperative hospital stay was comparable after ASH and LSH. Operating times were significantly longer with LSH, but estimated blood loss was greater in the ASH group. No intraoperative complications occurred in either group, and no patient was transfused. Self-rated pain 6 hours postoperatively was less in women having LSH. Follow up at 6 weeks showed that patients having ASH required approximately 10 more disability days than those in the LSH group. There were no differences in the number of days analgesics were required or the time needed to resume normal activities. At 6 months, 87% of women having ASH and 91% of those in the LSH group were satisfied or very satisfied with the overall results. More than 90% of women in both groups would recommend their procedure to others. When using a multimodal intervention program of postoperative care, the choice between ASH or LSH may be less important than is generally believed with regard to postoperative time in the hospital and long-term patient satisfaction.