Results of Total Laparoscopic Hysterectomy for Benign Diseases in Bangkok Metropolitan Administration Medical College and Vajira Hospital

Abstract

Results of Total Laparoscopic Hysterectomy for Benign Diseases in Bangkok Metropolitan Administration Medical College and Vajira Hospital

Sarwinee Ratchanon MD, MSc (Reproductive Biology) *

Prateep Hanidhikul MD **

Pongthorn Virojchaiwong MD, MSc (Health Economic) *

Anusorn Triwitayakorn MD *

Budsaba Wiriyasirivaj MD, MSc (Epidemiology), MSc (Clinical Embryology) *

* Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

** Special instructor of Endoscopic Surgery, Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

Objective: To study baseline characteristics, operative time, operative blood loss, conversion rate, complications and duration of postoperative hospital stay in patients who underwent total laparoscopic hysterectomy for benign diseases and to compare operative time and operative blood loss in overweight and obese patients to normal-weight patients.

Study design: Descriptive study.

Subjects: A total of 125 women who underwent total laparoscopic hysterectomy for benign diseases at BMA Medical College and Vajira Hospital from January 2000 to December 2006 were enrolled.

Methods: Patients' characteristics, intra-operative data, complications and hospital stay were collected from hospital records.

Main outcome measures: Age, diagnosis or indications for surgery, operative time, operative blood loss, conversion rate, complications and duration of postoperative hospital stay.

Results: The average age of the study population was 42.8 ± 8.5 years, ranged from 10 to 63 years. The most common diagnoses or indications for surgery were myoma uteri, myoma uteri with adenomyosis and adenomyosis. The operative time and operative blood loss were 267.8 ± 74.4 minutes and 302.7 ± 287.3 ml, respectively. Six of all were converted to total abdominal hysterectomy with conversion rate of 4.8%. Only one case (0.8%) had major complication of urinary bladder injury. The minor complication rate was 38.4%. The duration of postoperative hospital stay was 3.9 ± 2.0 days. Operative time and operative blood loss were more in overweight and obese patients compared to normal-weight patients, but without statistical significance.

Conclusion: Total laparoscopic hysterectomy for benign diseases can be done successfully with low major complication, although minor complications were high. Overweight and obesity patients had longer operative time and more operative blood loss, but without statistical significance.

Vajira Med J 2008 ; 52 : 5 - 13