Comparative study of surgical results between total abdominal hysterectomy and total laparoscopic hysterectomy in a tertiary hospital: a 2 year retrospective study

Abstract

Background: Since the introduction of Laparoscopic hysterectomy by Reich in 1989, it has become a widely accepted technique worldwide. The aim of the study was to compare the surgical results between Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH).Methods: We conducted a retrospective study at Women’s center and hospitals between June 2014 to May 2016, 32 patients who underwent TAH and 55 patients who underwent TLH, were included.Results: We observed that there was no significant difference between the two groups in respect to patient's demographic characteristics, indication of surgery, uterine size, or with history of previous pelvic surgery. Duration of surgery was found to be longer in TLH than TAH (124±39.7 min vs. 104.7±39.8 min). The length of hospital stay was less in TLH than TLH (P-0.0001) and the amount of blood loss were also less in TLH than TAH (103±149 ml versus 243±210 ml). There was no significant difference in view of intra and post operative complications. Hemoglobin change was statistically significant and is more with TAH than TLH (1.57±0.7g% versus 1.12±0.7g%).Conclusions: This study showed that TLH can be safely performed by the experienced surgeon in order to reduce the blood loss, duration of hospital stay and the quality of life.

A comparative study between total laparoscopic hysterectomy and total abdominal hysterectomy for benign uterine conditions

“…This observation was similar to previous studies. 5,7,15,24 In our study, no intraoperative complications were noted in both TLH and TAH group. 1,5,9,14,22 No patient in TLH group, required to conversion to abdominal hysterectomy.…”

“…In our study, subjects distributed according to indication of surgery (PALM-COIEN) included fibroid uterus, adenomyosis, pelvic inflammatory disease, endometrial hyperplasia, endometrial polyps, chronic cervical and pyrometers among which fibroid was the most common indication in both the groups (TAH>TLH) and these were comparable in both the groups, no statistical significance was found. 1,5,21,26 In our study mean operative time for TLH group was 89.34 minutes compared to 46.6 minutes in TAH group, this difference was statistically significant. Operative time more in TLH group then TAH group.…”

“…There was no statistical significance found in both groups for age and parity. 1,5,8,22,27,30,31 In our study patient's demographic factors (religion, residence, literacy and SES) were also compared between the two groups, no statistical difference was found (p>0.05). 6,14,30 In TLH group (38.51%) and in TAH group (35.71%) showed previous history of surgery which is almost equal in both group but no impact was seen on route of surgery with respect to all comparable factor due to previous history of surgery.…”

“…Similar results were observed in various studies. 1,5,8,16,20,29 Operative time can be less in TLH group depends on surgeons experience and expertness in skill of surgery and assistance of the man power.…”

“…3 looks better, more post-operative satisfaction and better quality of life due to small abdominal incision in TLH surgery. [4][5][6]9 But because necessity of comprehensive surgical education and equipment today still a lot of gynaecologists prefer abdominal surgery. 21 However complication in laparoscopic procedure depends on surgical experience according to previous studies.…”