Comparison of Laparoscopically Assisted Vaginal Hysterectomy and Total Abdominal Hysterectomy

Abstract

Background: Hysterectomy is the second most common major procedure following cesarean section in many countries while the abdominal hysterectomy is by far the most common surgical procedure. The comparison of laparoscopic assisted vaginal hysterectomy and abdominal hysterectomy was the goal of our study. Methods: A randomized clinical trial was performed in 51 patients who were elective candidates for hysterectomy for nonmalignant reasons in Omolbanin hospital affiliated to Mashad University of Medical Sciences from 2005 to mid 2007. By simple random sampling method, 25 patients were elected for laparoscopic assisted vaginal hysterectomy (LAVH) and 26 patients were put in the abdominal hysterectomy group. Demographic, preoperative and postoperative data were recorded in a questionnaire. After checking normality, the data were analyzed by student's t-test and chi-square when applicable. P < 0.05 considered as significance level. Findings: There was no difference in procedure time and total length of hospital stay between laparoscopic assisted vaginal hysterectomy and abdominal hysterectomy (P = 0.856, P = 0.537, respectively). The analgesics use was significantly lower in the laparoscopic assisted vaginal hysterectomy group than the other (P = 0.001) while the amount of blood loss was significantly higher in laparoscopic assisted vaginal hysterectomy group (P = 0.001). Return to normal daily activity was more reported to be good in the laparoscopic assisted vaginal hysterectomy in the follow-up visit after lapse of 2 weeks after operation (P = 0.330). Conclusion: As a whole, our study showed laparoscopic assisted vaginal hysterectomy to be a safe and recommended alternative to abdominal hysterectomy. Key words:Total abdominal hysterectomy, Blood loss, Postoperative, Intraoperative complications.