Laparoscopic hysterectomy versus total abdominal hysterectomy: a comparative study.
OBJECTIVE
The objective of this study was to compare the intraoperative and short-term postoperative complications of laparoscopic hysterectomy and total abdominal hysterectomy.


METHODS
Retrospective study of 167 women who had laparoscopic hysterectomy and 119 women who had total abdominal hysterectomy. For assessing the learning curve, the laparoscopic hysterectomies were further subdivided to the first 30 hysterectomies and the later hysterectomies. For data analysis Student's t-test, chi2-test and Fisher's exact test were used.


RESULTS
There were no statistically significant differences between the two groups for age, body mass index, previous abdominal surgery, uterine weight, first postoperative day hemoglobin drop, blood transfusion and major or minor complications rate. Operation time was significantly longer for laparoscopic than abdominal hysterectomy (156+/-40 and 91.2+/-33 min, respectively; P<0.001) but the length of hospital stay was significantly shorter (3.9 and 6.55 days, respectively; P<0.001). The conversion rate of laparoscopic hysterectomy was 1.8% (three cases).


CONCLUSIONS
Laparoscopic hysterectomy can be safely done even during the learning curve with a low and reasonable complication rate, and a shorter hospital stay but with longer operation time. As experience is gained the operation time, complication rate and hospital stay are decreased.
Vaisbuch
Edi
E
Department of Obstetrics and Gynecology, Kaplan Medical Center (Affiliated to the School of Medicine, Hebrew University and Hadassah), Rehovot 76100, Israel. vaisbuch@bezeqint.net
Goldchmit
Chen
C
Ofer
Dganit
D
Agmon
Arnon
A
Hagay
Zion
Z
D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000706:statistics & numerical data*; D007431:Intraoperative Complications; D007557:Israel / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008499:Medical Records; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome