Comparison study on results of LAVH according to prior abdominal surgery

Ku, Chun Hoe; Yoon, Seung Jun; Lee, Ji Seung; Lee, Hong Kyoon; Lee, Ki Bum

Abstract

OBJECTIVE
To evaluate the result of laparoscopically assisted vaginal hysterectomy (LAVH) according to history of prior abdominal surgery.
METHODS
From January, 2003 to June, 2005, a total of 504 patients were performed LAVH at our Hospital. The patients were divided into 2 groups: Group of non prior abdominal surgery (Op. Hx(-) group) included 262 cases and group of prior abdominal surgery (Op. Hx(+) group) had 242 cases. We reviewed medical records and analyzed these cases regarding age, parity, weight, height, operation indication, operation outcome, duration of hospitalization and complication.
RESULTS
There were no differences in terms of patients' mean age, parity, weight and height, and indications for surgery between the two groups. Mean operation time of Op. Hx(+) group (86.9+/-28.2 min) was longer than Op. Hx(-) group (80.7+/-20.0 min). There was no statistical difference on mean postoperative hemoglobin drop and mean uterine weight between the 2 groups. Mean hospital stay of Op. Hx(+) group (4.6+/-1.7 days) was longer than Op. Hx(-) group (4.3+/-0.9 days). The incidence of major surgical complications was higher in Op. Hx(+) group (10 cases - 4.1%) than Op. Hx(-) group (3 cases - 1.2%). In case of blader injury, Op. Hx(+) group (5 cases) was higher than Op. Hx(-) group (0 case). Op. Hx(+) group had 2 ureteral injuries and 1 rectal injury but there were no statistical differences. In case of trocar site bleeding, both group had 2 cases trocar site bleeding respectively. Op. Hx(-) group had 1 inferior vena cava injury but there was no statistical difference.
CONCLUSION
At the time of LAVH, the incidence of bladder injury was higher in group of patients with history of prior abdominal surgery. So special attention should be paid to prevent bladder injury.