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A comparison of vaginal, laparoscopic‐assisted vaginal, and minilaparotomy hysterectomies for enlarged myomatous uteri
Author(s) -
Sesti Francesco,
Calonzi Francesca,
Ruggeri Velia,
Pietropolli Adalgisa,
Piccione Emilio
Publication year - 2008
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2008.07.006
Subject(s) - medicine , hysterectomy , blood loss , ileus , surgery , laparoscopy , gynecology
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.