Laparoscopically Assisted Vaginal Hysterectomy versus Total Abdominal Hysterectomy: A case control study

Abstract

Objective:  To compare the short-term results between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH) in Gynecological Laparoscopic Center, Bangkok Metropolitan.

Method: The medical records of seventy six patients who had undergone total abdominal hysterectomy in corresponding periods of the equal number of the patients who underwent laparoscopically assisted vaginal hysterectomy in which 152 women (72 in each group) aged 31-67 years were observed and the medical records reviewed.

Results: The patients' demographic characteristics were similar in both groups. The menan operating time for LAVH was 140 ± 48 min (mean ± SD) and 92 ± 31 min for TAH (p<0.001).  The mean length of postoperative hospitalization was 2.9 ± 2.0 days in the LAVH group versus 5.2 ± 2.2 days in the TAH group (p<0.001).  There were no significant differences in average intraoperation blood loss from both groups (p=0.53).  But in LAVH group showed less parenteral analgesia than TAH (0.8 ± 0.9 dosed versus 1.4 ± 0.9 doses, p<0.001).  The post-operative fever was found in 3.9% in LAVH group compared to 26.3% in TAH group (p<0.001).  The hospital costs were 13,999 ± 6,697 Baht (range 5,779 - 49,859) for LAVH group and 11,010 ± 4,609 Baht (range 7,282 - 37,287) for TAH group (p=0.002).

Conclusion: This study shows that the laparoscopic approach can be used effectively in hysterectomy with various means of significant acceptance.