A comparative analysis of hysterectomies

Abstract

The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital. Methods. A retrospective review of medical histories was performed for women who had undergone three different types of hysterectomies (laparoscopic, vaginal, and abdominal) at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital during 2004–2005. Results. A total of 602 hysterectomies were performed: 51 (8.5%) laparoscopic, 203 (33.7%) vaginal, and 348 (57.8%) abdominal. The lowest complication rate occurred in patients who underwent laparoscopic hysterectomy (n=5, 9.8%) and the highest – abdominal hysterectomy (n=88, 25.2%) (P<0.05). More complication occurred after abdominal as compared to vaginal hysterectomy (n=88, 25.2% vs. n=20, 9.9%, respectively; P<0.05). There was no statistically significant difference in complication rate comparing laparoscopic and vaginal hysterectomies (P=0.26). The amount of blood loss depended on the type of hysterectomy – less blood was lost during laparoscopic and more during abdominal hysterectomy (123.4 vs. 308.5 mL, respectively; P<0.01). A significantly higher blood loss was observed during abdominal hysterectomy as compared to vaginal (195.3 mL) and vaginal as compared to laparoscopic hysterectomy (P<0.01). The mean length of hospital stay differed comparing all three types of hysterectomies: the shortest stay of 8.6 days was after laparoscopic, the longest of 13.7 days – after abdominal hysterectomy. The mean hospital stay was statistically significant shorter for vaginal hysterectomy compared to abdominal hysterectomy (9.1 vs. 13.7 days, P<0.01). The difference in mean length of hospital stay was insignificant comparing laparoscopic and vaginal hysterectomies (P>0.05). Conclusions. Abdominal hysterectomy was the most common procedure performed. The type of hysterectomy influenced the rate of complications – the lowest complication rate was after laparoscopic and vaginal hysterectomies. The amount of blood loss depended on the type of hysterectomy – the lowest was during laparoscopic hysterectomy. Abdominal hysterectomy required on average a longer hospital stay compared with laparoscopic and vaginal hysterectomies.

A comparative study of total laparoscopic hysterectomy and non-descent vaginal hysterectomy for treatment of benign diseases of uterus

“…But Aniuliene R, et al stated that the difference in mean length of hospital stay was insignificant comparing laparoscopic and vaginal hysterectomies (P>0.05). 7 There were no major complications during the operative procedures in our intervention which is consistent with the findings of Walsh CA, et al 10 25 patients were taken in each arm for the present study. This is consistent with the prevalence of benign diseases of uterus in our institution and the study period of 1 year.…”

“…In Table 5, the post-operative complication is slightly more in case of NDVH than in TLH. [6][7][8][9] Between TLH and NDVH, we found TLH has a higher mean operating time (99.24min) compared to NDVH (94.76min). But the p value for comparison of this parameter is 0.0915 which is not statistically significant.…”

Non-descent vaginal hysterectomy versus total abdominal hysterectomy in fibroid uterus: a comparative study in tertiary care hospital in Uttarakhand, India

“…14 Chen B et al reported significantly less blood loss in vaginal group (mean 30.4 ml) compared to abdominal group (mean 70.3 ml). 13 The average blood loss in TAH group in our study was 80 ml more than the NDVH group.…”

Minimally invasive hysterectomy for benign disease: our experience study

“…The quoted blood loss figures in the literature show that laparoscopic surgery definitely is beneficial in terms of blood loss as compared to abdominal surgery. 21 The reason probably is the use of diathermy as the main modality for pedicles which reduces the blood loss.…”