A retrospective and comparative study between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH).
OBJECTIVE
To compare the results of laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH).


METHODS
Retrospective and comparative study.


METHODS
Department of Obstetrics and Gynecology, Ranong Hospital.


METHODS
26 cases of LAVH and 63 cases of TAH who were operated on from February 1996 to September 2001.


METHODS
Medical records of the patients were reviewed, by the same surgeon. The percentage and mean +/- SD data were analyzed a using chi-squared test and Fisher-Exact test to find the association. A p-value of < 0. 05 was regarded as significant. EVALUATION OF THE OUTCOMES: Operative time, estimated blood loss, parenteral analgesics, postoperative hospitalization, operative complications and operative cost.


RESULTS
The baselines characteristics of both groups were similar The mean operative time for the LAVH group was 147.11 +/- 19.82 minutes, and 94.90 +/- 7.76 minutes for the TAH group. The mean length of postoperative hospitalization was 3.0 +/- 0.95 days for the LAVH group versus 5.7 +/- 0.81 days in the TAH group. There was no significant difference in the amount of estimated blood loss (369.23 +/- 57.00 ml in the LAVH and 33.41 +/- 51.97 ml in the TAH, p = 0. 143). The LAVH group used fewer parenteral analgesics (meperidine) than the TAH group ( 64.42 +/- 17.56 mg versus 132.14 +/- 23.94 mg). The operative costs were 11,653.85 +/- 1111.48 baht in the LAVH group and 6424.60 +/- 555.09 baht in the TAH group. There was one bladder injury in the LAVH group but there was no complication detected in the TAH group.


CONCLUSIONS
There are some advantages as well as disadvantages in LAVH, compared to TAH. However, in Thailand the situation is not yet favorable; more learning experience is needed and more time to gain more confidence that LAVH is a more beneficial surgical technique.
Kulvanitchaiyanunt
Anurach
A
Department of Obstetrics and Gynecology, Pranungkloa Hospital, Nonthaburi, Thailand.
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007045:Hysterectomy, Vaginal / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome