A comparison of vaginal, laparoscopic-assisted vaginal, and minilaparotomy hysterectomies for enlarged myomatous uteri

Abstract Objective To compare the operative data and early postoperative outcome of vaginal hysterectomy (VH), laparoscopic-assisted vaginal hysterectomy (LAVH), and minilaparotomy hysterectomy (MiniLPT). Methods A total of 150 women who required hysterectomy for enlarged myomatous uteri were random...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2008-12, Vol.103 (3), p.227-231
Main Authors: Sesti, Francesco, Calonzi, Francesca, Ruggeri, Velia, Pietropolli, Adalgisa, Piccione, Emilio
Format: Article
Language:English
Subjects:
Analysis of Variance
Biological and medical sciences
Digestive system. Abdomen
Endoscopy
Enlarged uterus
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Humans
Hysterectomy, Vaginal - methods
Investigative techniques, diagnostic techniques (general aspects)
Laparoscopic-assisted vaginal hysterectomy
Laparoscopy - methods
Laparotomy
Length of Stay
Medical sciences
Middle Aged
Minilaparotomy hysterectomy
Myoma - surgery
Obstetrics and Gynecology
Postoperative Complications
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the genital tract and mammary gland
Tumors
Uterine myomas
Uterine Neoplasms - surgery
Vagina - surgery
Vaginal hysterectomy
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Summary:Abstract Objective To compare the operative data and early postoperative outcome of vaginal hysterectomy (VH), laparoscopic-assisted vaginal hysterectomy (LAVH), and minilaparotomy hysterectomy (MiniLPT). Methods A total of 150 women who required hysterectomy for enlarged myomatous uteri were randomly allocated into 3 treatment groups: VH (n = 50), LAVH (n = 50), and MiniLPT (n = 50). The primary outcome was hospital discharge time. The secondary outcomes were operative time, blood loss, paralytic ileus, postoperative pain, and intraoperative and early postoperative complications. Results Mean hospital discharge time was longest with MiniLPT, and shortest with VH ( P < 0.01). VH was the fastest operating technique, was associated with less blood loss, and resulted in shortest duration of paralytic ileus ( P < 0.01). No intraoperative complications occurred. Conclusion VH should be the preferred surgical approach in patients with enlarged myomatous uteri. When VH is not feasible, LAVH should be considered an alternative to MiniLPT. Further controlled prospective studies are required to confirm these results.
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2008.07.006