Abstract
Aim
The aim of this retrospective study was to assess and compare the clinical results of three hysterectomy techniques: abdominal hysterectomy (AH), vaginal hysterectomy (VH), and laparoscopic hysterectomy (LH).
Methods
A total of 2163 patients having undergone AH (n = 1226), VH (n = 426), and LH (n = 511) procedures were analyzed. The mean age, body mass index (BMI), parity, uterus weight, operation time, blood loss, duration of hospitalization, analgesic needs, intra- and postoperative complications, and indications for hysterectomy were analyzed and compared.
Results
There were no differences between the groups with respect to the BMI, parity, and intra- or postoperative major and minor complications. The operation time was significantly shorter in the VH group than in the other two groups (p < 0.001), and the blood loss was significantly lower in the LH group than in the others (p < 0.001). The duration of hospitalization and analgesic needs were the shortest in the LH group (p < 0.001), while the uterus weight and previous intra-abdominal surgery rate were the lowest in the VH group (p < 0.001).
Conclusion(s)
Despite the fact that the LH exhibited a longer operation time than the VH, the LH was considered to be a safe and effective surgical procedure due to the lesser blood loss, hospital stay, and analgesic needs.
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References
Doganay M, Yildiz Y, Tonguc E et al (2011) Abdominal, vaginal and total laparoscopic hysterectomy: perioperative morbidity. Arch Gynecol Obstet 284:385–389
Garry R (2005) The future of hysterectomy. BJOG 112:133–139
Silva-Filho AL, Reis FM, Noviello MB et al (2004) Factors influencing the operative time and complications of vaginal hysterectomy on non-prolapsed uterus. J Pelvic Med Surg 10:257–262
Nieboer TE, Johnson N, Lethaby A et al (2009) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 3:CD003677
Reich H, De Caprio J, Mc Glynn NF (1989) Laparoscopic hysterectomy. J Gynecol Surg 5:213–216
Donnez O, Jadoul P, Squifflet J et al (2009) A series of 3190 laparoscopic hysterectomies for benign disease from 1990 to 2006: evaluation of complications compared with vaginal and abdominal procedures. BJOG 116:492–500
Dolanbay M, Kutuk MS, Ozgun MT et al (2016) Laparoscopically-assisted vaginal hysterectomy for enlarged uterus: operative outcomes and the learning curve. Ginekol Pol 87:333–337
Schindlbeck C, Klauser K, Dian D et al (2008) Comparison of total laparoscopic, vaginal hysterectomy. Arch Gynecol Obstet 277:331–337
Wattiez A, Soriano D, Cohen SB et al (2002) The learning curve of total laparoscopic hysterectomy: comparative analysis of 1647 cases. J Am Assoc Gynecol Laparosc 9:339–345
Choosing the route of hysterectomy for benign disease. ACOG Committee Opinion No. 444 (2009) American College of Obstetricians and Gynecologists. Obstet Gynecol 114:1156–1158
ACOG Committee Opinion. Number 311, April 2005 (2005) Appropriate use of laparoscopically assisted vaginal hysterectomy. Obstet Gynecol 105:929–930
Farquhar CM, Steiner CA (2002) Hysterectomy rates in the United States 1990–1997. Obstet Gynecol 99:229–234
Maresh MJ, Metcalfe MA, McPherson K et al (2002) The VALUE national hysterectomy study: description of the patients and their surgery. BJOG 109:302–312
Gimbel H, Settnes A, Tabor A (2001) Hysterectomy on benign indication in Denmark 1988–1998. A register based trend analysis. Acta Obstet Gynecol Scand 80:267–272
Hoffman CP, Kennedy J, Borschel L et al (2005) Laparoscopic hysterectomy: the Kaiser Permanente San Diego experience. J Minim Invasive Gynecol 12:16–24
Heinberg EM, Crawford BL III, Weitzen SH et al (2004) Total laparoscopic hysterectomy in obese versus nonobese patients. Obstet Gynecol 103:674–680
Ribeiro SC, Ribeiro RM, Santos NC et al (2003) A randomized study of total abdominal, vaginal and laparoscopic hysterectomy. Int J Gynaecol Obstet 83:37–43
Hasson HM, Rotman C, Rana N et al (1993) Experience with laparoscopic hysterectomy. J Am Assoc Gynecol Laparosc 1:1–11
Abdelmonem A, Wilson H, Pasic R (2006) Observational comparison of abdominal, vaginal and laparoscopic hysterectomy as performed at a university teaching hospital. J Reprod Med 51:45–954
Makinen J, Johansson J, Tomas C et al (2001) Morbidity of 10,110 hysterectomies by type of approach. Hum Reprod 16:1473–1478
Garry R, Fountain J, Brown J et al (2004) EVALUATE hysterectomy trial: a multicentre randomised trial comparing abdominal, vaginal and laparoscopic methods of hysterectomy. Health Technol Assess 8:1–154
Sokol AI, Chuang K, Milad MP (2003) Risk factors for conversion to laparotomy during gynecologic laparoscopy. J Am Assoc Gynecol Laparosc 10:469–473
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ZI and HAI carried out the design and coordinated the study, participated in most of the experiments, and prepared the manuscript. HAI provided assistance in the design of the study. ZI and HAI prepared the manuscript. All authors have read and approved the contents of the manuscript.
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The study was approved by the Institutional Review Boards in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans and informed consent has been obtained from all the participants.
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Author ZI declares that she has no conflict of interest. Author HAI declares that he has no conflict of interest.
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Inal, Z.O., Inal, H.A. Comparison of abdominal, vaginal, and laparoscopic hysterectomies in a tertiary care hospital in Turkey. Ir J Med Sci 187, 485–491 (2018). https://doi.org/10.1007/s11845-017-1660-6
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DOI: https://doi.org/10.1007/s11845-017-1660-6