Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy (LAVH) and Total Abdominal Hysterectomy (TAH)

Choi, Yong Wook; Jin, Keon

Abstract

OBJECTIVE
To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH). METHOD: 60 of LAVH cases and 60 of TAH cases, which were performed at Dankook university hospital from April 1998 to December 2000. We analyzed the results with regard to patient's characteristics, indication of hysterectomy, weight of uterus, operation time, blood loss, hospital stay and complications.
RESULTS
Total 120 of hysterectomy cases (60 LAVH, 60 TAH) were enrolled in this study. All operations, LAVH and TAH, were performed by same surgeon. There were no significant differences in patient's characteristics (age, height, weight, parity) between the two groups. The main preoperative indication was myoma uteri, followed by adenomyosis, CIN III, for both LAVH and TAH. The mean uterine weight of TAH cases was larger than LAVH (214.8+/-88.1 gm for LAVH, 377.1+/-269.0 gm for TAH, p<0.05) cases. The operation time was longer in LAVH operation (114.3+/-31.4 min for LAVH, 93.7+/-30.2 min for TAH, p<0.05). The blood loss was not significantly different between the two groups (185.5+/-53.3 ml for LAVH, 205.8+/-65.8 ml for TAH, p>0.05). The hospital stay of LAVH was significantly shorter than TAH (4.9+/-0.6day for LAVH, 7.5+/-1.9day for TAH, p<0.05).
CONCLUSION
In the comparison of LAVH and TAH operation, we conclude that LAVH can be considered as the first choice when determining hysterectomy method, unless contraindication prevents it. LAVH has advantages of shorter hospitalization and the acceptable complication rate.