A comparative Study for morbidity and Compilication in Total AbdominalHysterectomy ; -Open Versus Closed Vaginal Cuff

Kim, Woo Gyeong; Kim, Hyun Chan

Abstract

Post-operative morbidity and complication, focused on open versus closed vaginal cuff, were compared. The patients were divided into two groups according to the method of cuff management(open cuff : n=53, closed cuff : n=52). From Jan, 1990 to Dec. 1994 one hundred five cases of total abdominal hysterectomy on the benign uterine disease were carried out by the same operator at the Dept. of Ob/Gyn. Pusan Paik Hospital. The vaginal cuff was opened during the first half periods(1990. 1~1993.3), and it was closed during the later peroids(1993.4 ~ 1994.12). As to the postoperative morbidity and complication(closed : open), urinary tract infection(9.4% : 5.8%), vaginal cuff infection(7.5% : 3.8%), febrile morbidity(3.8% : 3.8%), wound infection(1.9% : 3.8%), pelvic hematoma(0: 1.9%) developed but there were no statistical differences between the two groups. Granulation tissue formation on the vaginal cuff was found in 26 cases(49.1%) of the open cuff and in 18 cases(34.6%) of the closed cuff(p=0.134, X(2) test ) within 6 months after operation. Post operative increased vaginal discharge developed in 7 cases(13.2%) of the open cuff and in 10 cases (19.2%) of the closed cuff group(p=0.516, Fisher's Exact test).