Comparison of surgical outcomes after laparoscopy-assisted vaginal hysterectomy and total laparoscopic hysterectomy

Park, Hyun; Choi, Min Chul; Yoon, Bo Sung; Seong, Seok Ju; Cho, Yeon Kyung; Shin, Joong Sik; Jun, Hye Sun; Shim, Jeong Yun; Kim, In Hyun; Park, Chong Taik

Abstract

OBJECTIVE
To compare the surgical outcomes between laparoscopy-assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH).
METHODS
The data were collected retrospectively from hospital records. Between September 2006 and August 2007, Patients undergone with LAVH (93 cases) and TLH (142 cases) with pathologic reports of leiomyoma or adenomyosis were enrolled. The characteristics and surgical results were compared according to the operation type. The correlations among the variables were analyzed with multiple linear regression.
RESULTS
Between two groups, the characteristics of patients were similar such as age, body mass index, surgical history, and pathologic findings. In the univariate analysis, the differences of operation duration and blood loss between LAVH (129.0+/-34.5 min, 385.5+/-296.1 mL) and TLH (123.6+/-40.8 min, 294.7+/-285.4 mL) were significant (P<0.050). Specimen weight was slightly heavier in LAVH (378.7+/-211.7 g vs. 316.9+/-170.1 g, P=0.060), Admission duration (5.63+/-1.61 day vs. 5.71+/-1.61 day) and the incidence of complications (10.8% vs. 14.0%) were indifferent to the groups (LAVH vs. TLH, P>0.050). In multivariate analysis, blood loss was correlated with operation duration and specimen weight (P=0.000) but not with operation type (P=0.213).
CONCLUSIONS
LAVH tends to be selected in larger uteri and results in more blood loss and longer operation duration. Operation type (LAVH or TLH) does not affect blood loss which is related with operation duration and uterine weight.