title: Total laparoscopic hysterectomy for oncological indications with outcomes stratified by age.
abstract: OBJECTIVE
  We hypothesize that there is no difference in surgical outcomes of patients undergoing total laparoscopic hysterectomy (TLH) for various oncological indications when stratified by age categories.
  
  
  METHODS
  Data were analyzed by ANOVA and chi-square test with significance of P < 0.05, stratified by age (young: <50 years, middle: 50-64, senior age 65+).
  
  
  RESULTS
  There were 208 patients, age 26-86 years: 85 young, 82 middle, and 41 senior women. Preoperative diagnoses included 13 cases of cervical dysplasia, 10 cervical or upper vaginal carcinoma, 60 endometrial neoplasias, 22 prophylaxes of familial ovarian carcinoma, 95 with complex pelvic mass, and 8 with early ovarian carcinoma. Mean body mass index (BMI) was 27.2 kg/m(2) for all groups. Parity increased with age (1.0, 1.3, and 2.0; P = 0.001). Surgical duration was longer for young than middle or senior (168, 147, and 140 min, P = 0.0095). All groups had a similar mean blood loss (133 cc, ns) and similar mean length of hospital stay (1.8 days, ns). Overall complication rate was 7.7% with no variance by age: one seroma, one hematoma, one diverticulitis, one incisional hernia, one vaginal nonhealing, one adhesive bowel obstruction, and five urologic complications (two bladder, three ureteral; four treated with catheter or stent, one reimplant. Reoperation was required in 2.8%.
  
  
  CONCLUSIONS
  Null hypothesis accepted: TLH appears feasible and safe for oncological practice indications throughout the life span. This pilot data can facilitate guidelines for a randomized controlled trial of TLH with TAH and laparoscopic assisted vaginal hysterectomy (LAVH).
authors.affiliation: Gynecologic Oncology Associates, Portola Valley, CA 94028, USA. ohanlan@AOL.com
authors.forename: Katherine A
authors.initials: KA
authors.lastname: O'Hanlan
authors.forename: Gloria Shining
authors.initials: GS
authors.lastname: Huang
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Lopez
authors.forename: Anne-Caroline
authors.initials: AC
authors.lastname: Garnier
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome