Abdominal, vaginal and total laparoscopic hysterectomy: perioperative morbidity
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The aim of our retrospective study was to assess and to compare the surgical complications of hysterectomy regarding the choice of procedure [abdominal (AH), vaginal (VH), and total laparoscopic hysterectomy (TLH)].
A total of 6,480 patient charts undergone hysterectomy were retrospectively analyzed. Data including transfusion, bladder, ureteral and bowel injury, cuff dehiscence, pulmoner embolus, febrile morbidity, hematoma, reoperation, pelvic wall problems were gathered. The Chi-square test and Student’s t test were used in the statistical analysis.
The most common perioperative complication was blood transfusion which occurred in 114 patients (2.6%). VH patients required significantly less blood transfusion than AH (2.1, 2.6%, respectively). AH had significantly more bladder injury than VH (0.7, 0.4%, respectively). AH had significantly more ureteral injury than VH (0.2, 0.1%, respectively). AH had the same bowel injury as VH (0.1%). AH and VH necessitated significantly more reoperation than TLH (0.4, 0.2, 0.0%, respectively).
To our study, VH ensures less complication rates than AH. In experienced centers, VH can be a reliable alternative to AH. Controlled prospective studies with large patient volumes are required to compare TLH and VH according to complication rates.
KeywordsHysterectomy Complication Laparoscopic Vaginal Abdominal
Conflict of interest
- 3.Hwang JL, Seow KM, Tsai YL, Huang LW, Hsieh BC, Lee C (2002) Comparative study of vaginal, laparoscopically assisted vaginal and abdominal hysterectomies for uterine myoma larger then 6 cm in diameter or uterus weighting at least 450 g: a prospective randomized study. Acta Obstet Gynecol Scand 81(12):1132–1138PubMedCrossRefGoogle Scholar
- 18.Garry R, Fountain J, Mason S, Hawe J, Napp V, Abbott J, Clayton R, Phillips G, Whittaker M, Lilford R et al (2004) The evaluate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ 328:129PubMedCrossRefGoogle Scholar