Total Laparoscopic Hysterectomy versus Total Abdominal Hysterectomy in Uterine Tumors

Abstract

Background: laparoscopic hysterectomy (LH) rates have increased but abdominal hysterectomy (AH) still high and often the first choice for many surgeons even with most of studies reported that the minimal access method offers significant patient benefit over open surgery. Aim of the Work: we aimed to compare the outcome of total laparoscopic hysterectomy as regard the result and safety compared to total open abdominal hysterectomy in cases of uterine tumors. Patients and Methods: this prospective randomized controlled study performed on 25 patients who underwent LH (group 1) compared to 25 patients who underwent AH (group 2). The mean age of the cases, body mass index (BMI), duration of operation, estimated blood loss (EBL), rate of complications, post-operative hospital stay and convalescence time were compared for two groups. Results: LH was associated with a significantly longer operating time (139.96±22.66 minutes vs. 106.54±21.8 minutes P 0.001). As regard intraoperative complications and estimated blood loss there was no difference in both groups. In LH group the pain score and analgesia requirements in post-operative period were significantly less with fewer requiring opioid analgesia. There was a highly significant difference between groups in postoperative wound infection which was higher in AH group. LH was also associated with a significantly shorter inpatient hospital stay (2.22 days vs. 5.52 days P= 0.022) and earlier returned to normal life (7.5 days vs. 20.6 days P<0.001). Conclusion: total laparoscopic hysterectomy is safe and feasible procedure in treatment of uterine tumors with accepted peri-operative morbidity and good improvement of quality of life post-operative.