The well-being of women following total laparoscopic hysterectomy versus total abdominal hysterectomy for endometrial cancer

Abstract

Total laparoscopic hysterectomies (TLH) are increasingly being used in the management of endometrial carcinoma. There is insufficient research on patient satisfaction and well-being after TLH for malignant endometrial disease. The objective of this questionnaire-based retrospective study was to compare post-operative well-being after total abdominal hysterectomy (TAH) versus TLH for endometrial carcinoma. Eighty-one women who underwent a TLH or TAH for endometrial carcinoma and atypical endometrial hyperplasia in a tertiary UK hospital were the sample of this study. Data regarding well-being and post-operative satisfaction were obtained via a self-administered questionnaire. Results were analysed. The primary outcome was health-related well-being. The length of post-operative hospital stay, satisfaction with scar, return to normal activities, severity of post-operative pain and sexual activity were secondary outcome measures. Seventy women responded (TAH n = 41; TLH n = 29). There was no difference between overall well-being between both groups. TLH group reported a shorter hospital stay (TAH = 4 days; TLH = 2 days; p = 0.000), a quicker return to normal activities with 24.4% of the TAH group taking 12 weeks or more, compared to 3.4% of the TLH group (p = 0.019) and increased satisfaction with their scars than the TAH group (‘very’ or ‘fairly satisfied’ with scar TAH 92.7%; TLH 100%; p = 0.039). This study has found that patients’ well-being after endometrial carcinoma is not significantly affected by surgical technique. This is in line with previous studies using patients with benign disease. However, laparoscopic techniques do have a reduced impact on a patient’s life through shorter hospital stays and quicker return to normal activities