Comparison of two procedures for laparovaginal hysterectomy: a randomized trial.
OBJECTIVE
To compare peroperative parameters of two variants of a laparovaginal hysterectomy in surgical management of gynecological conditions.


METHODS
A prospective randomized study of 70 laparovaginal hysterectomies performed by the same two surgeons for disease of female pelvic organs. The following criteria were studied: indication for surgery, previous surgery, duration of the procedure, recovery, hospital stay, blood loss, tissue damage markers, hysterectomy proportions and complication incidence. Statistical analysis was performed using the non-parametric chi(2)-test and non-parametric Fischer's exact probability test when appropriate, with a level of significance P=0.05.


RESULTS
Totals of 38 (54.3%) laparoscopy-assisted vaginal and 31 (45.7%) vaginally assisted laparoscopic hysterectomies were performed for fibroma as the main indication. Conversion to laparotomy was applied in only one patient. The VALH group (P=0.01) showed both fewer procedures and shorter hospital stay with insignificant blood loss.


CONCLUSIONS
The two variants of a laparovaginal hysterectomy appear to be safe and appropriate, effective procedures for women with gynecological conditions. Furthermore, vaginally assisted laparoscopic hysterectomy has been shown to be superior to laparoscopy-assisted vaginal hysterectomy in terms of shorter operating time and greater palliative effect upon the complex of uterosacral ligaments. Laparoscopic surgery can alter the relationship between vaginal and abdominal hysterectomy.
Holub
Z
Z
Department of Gynecology and Obstetrics, Endoscopic Training Center, Baby Friendly Hospital Kladno, Kladno, Czech Republic.
Jabor
A
A
Kliment
L
L
Vorácek
J
J
Lukác
J
J
D000328:Adult; D004617:Embolism / Q000209:etiology; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome