Laparoscopic supracervical hysterectomy versus laparoscopic-assisted vaginal hysterectomy.
OBJECTIVE
To compare laparoscopic supracervical hysterectomy (LSH) with laparoscopic-assisted vaginal hysterectomy (LAVH) in terms of indications, pathology, length and weight of removed uteri, operative time, intraoperative blood loss, intra and postoperative complications, and later sexual function.


METHODS
Cohort retrospective analysis of consecutive cases (Canadian Task Force classification II-3).


METHODS
Hutzel Hospital, Detroit Medical Center,Wayne State University, Detroit, Michigan; Vert-Pre Nouvelle Clinique, Geneva, Switzerland; and Benha University Hospitals, Egypt.


METHODS
Two hundred and fifty-nine women.


METHODS
LSH and LAVH.


RESULTS
Patients in both groups were matched regarding age, indications, and pathology of the removed uteri. Blood loss with the LSH procedure was significantly lower than it was with the LAVH procedure (mean 125 +/- 5 vs 149 +/- 7 mL, p =.001). Patients that underwent LSH had significantly shorter operating times (mean 120 +/- 3 vs 150 +/- 5 minutes, p =.007). The length of the removed uteri was 14.2 +/- 0.5 cm (range 5.2-18) in the LSH group versus 11.8 +/- 0.4 cm (range, 5.6-14) in the LAVH group. Weight of the removed uteri was 280 +/- 6 g (range, 65-750) in the LSH group compared with 235 +/- 8 g (range, 59-560) in the LAVH group. There was no difference between the groups in hospital length of stay. The number of complications was less in the LSH group (3/123, 2.4%) compared with 5/136 (3.7%) in the LAVH group. Sexual function after surgery was better in the LSH group.


CONCLUSIONS
After exclusion of preoperative cervical disease, LSH can be considered as a safer alternative to LAVH in patients that are candidates for laparoscopic hysterectomy.
El-Mowafi
Diaa
D
Department of Obstetrics and Gynecology, Benha Faculty of Medicine, Benha, Egypt.
Madkour
Wahba
W
Lall
Chitranjan
C
Wenger
Jean-Marie
JM
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000379:methods; D015907:Hysteroscopy; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010149:Postoperative Pain; D019106:Postoperative Hemorrhage; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000473:pathology* / Q000601:surgery*