A comparison of vaginal, laparoscopic-assisted vaginal, and minilaparotomy hysterectomies for enlarged myomatous uteri
Received 4 June 2008; received in revised form 10 July 2008; accepted 10 July 2008. published online 05 September 2008.
Abstract
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.
Section of Gynecology and Obstetrics, School of Medicine, Tor Vergata University Hospital, Rome, Italy
Corresponding author. Section of Gynecology and Obstetrics, Department of Surgery, School of Medicine, Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy. Tel./fax: +39 06 2090 2921.
ABSTRACT