Comparison of two procedures for laparovaginal hysterectomy: a randomized trial

• Published in: European journal of obstetrics & gynecology and reproductive biology 2000-05, Vol.90 (1), p.31-36
• Main Authors: Holub, Zdenek, Jabor, Antonı́n, Kliment, Lev, Voráček, Josef, Lukác, Jan
• Format: Article
• Language: English
• Subjects: Abdominal hysterectomy; Adult; Biological and medical sciences; Comparison; Embolism - etiology; Female; Humans; Hysterectomy, Vaginal - adverse effects; Hysterectomy, Vaginal - methods; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Length of Stay; Medical sciences; Middle Aged; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Treatment Outcome; Vaginal hysterectomy
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/S0301-2115(99)00221-3

Objective: To compare peroperative parameters of two variants of a laparovaginal hysterectomy in surgical management of gynecological conditions. Methods: A prospective randomized study of 70 laparovaginal hysterectomies performed by the same two surgeons for disease of female pelvic organs. The following criteria were studied: indication for surgery, previous surgery, duration of the procedure, recovery, hospital stay, blood loss, tissue damage markers, hysterectomy proportions and complication incidence. Statistical analysis was performed using the non-parametric χ 2-test and non-parametric Fischer’s exact probability test when appropriate, with a level of significance P=0.05. Results: Totals of 38 (54.3%) laparoscopy-assisted vaginal and 31 (45.7%) vaginally assisted laparoscopic hysterectomies were performed for fibroma as the main indication. Conversion to laparotomy was applied in only one patient. The VALH group ( P=0.01) showed both fewer procedures and shorter hospital stay with insignificant blood loss. Conclusion: The two variants of a laparovaginal hysterectomy appear to be safe and appropriate, effective procedures for women with gynecological conditions. Furthermore, vaginally assisted laparoscopic hysterectomy has been shown to be superior to laparoscopy-assisted vaginal hysterectomy in terms of shorter operating time and greater palliative effect upon the complex of uterosacral ligaments. Laparoscopic surgery can alter the relationship between vaginal and abdominal hysterectomy.