Revista Chilena de Obstetricia y Ginecología (Jan 2005)
HISTERECTOMÍA VAGINAL, ABDOMINAL Y VAGINAL ASISTIDA POR LAPAROSCOPIA: UN ANÁLISIS PROSPECTIVO Y ALEATORIO
Abstract
Objetivo: Evaluar el resultado a corto plazo de tres técnicas de histerectomía. Pacientes: Se analizaron prospectivamente 117 pacientes sin prolapso uterino, ingresadas al Hospital Padre Hurtado entre Octubre 2000 y Julio 2003, las que se distribuyeron al azar y fueron sometidas a una de las tres técnicas de histerectomía: vaginal (HV), abdominal (HAT) y vaginal asistida por laparoscopia (HVLP). Resultados: El tiempo operatorio fue significativamente mayor en el grupo HVLA comparado con el de HAT (95,5 v/s 74,0 minutos, pWe present a prospective analisis of three techniques of total hysterectomy in patients without uterine prolapse: vaginal (HV), abdominal (HAT) and laparoscopic assisted vaginal hysterectomy (HVLA). Objective: To evaluate short term outcome of three techniques of hysterectomy. Patients: 117 women admitted at Padre Hurtado Hospital between October 2000 and July 2003 were evaluated and randomly distributed to one of the three techniques above mentioned. Results: Surgical time was higher in the HVLA group when compared with the HAT (95,5 v/s 74,0 minutes, p < 0,001), and this one was higher than surgical time of the HV (74,0 v/s 52,9 minutes, p < 0,001). There were not differences in intraoperative complications nor in the need of analgesic drugs. The HAT group presented more postoperative complications. Hospital stay was longer in the HAT group than in the HVLA and HV, with no differences between them. HVLA cost was higher in HVLA than HAT and HV respectively. Conclusions: According to our results, vaginal approach should be the first option for hysterectomy in patients without uterine prolapse in selected cases. HAT must be considered when vaginal or laparoscopic techniques are not indicated
