title: Laparoscopic-assisted vaginal hysterectomy versus minilaparotomy hysterectomy: a prospective, randomized, multicenter study.
abstract: OBJECTIVE
  The aim of this study was to compare operative and early postoperative outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH) and minilaparotomy in a randomized clinical trial including patients undergoing total hysterectomy for benign gynecologic disease and having 1 or more of the generally considered contraindications to vaginal route.
  
  
  METHODS
  Prospective, randomized, multicenter trial (Canadian Task Force classification I).
  
  
  METHODS
  Departments of Gynecology from 3 major university hospitals in Rome.
  
  
  METHODS
  Eighty-one patients who were candidates for abdominal hysterectomy.
  
  
  METHODS
  Laparoscopic-assisted vaginal hysterectomy and minilaparotomy hysterectomy.
  
  
  RESULTS
  Forty patients were randomized to LAVH and 41 to minilaparotomy. Characteristics of patients and indications for surgery in the 2 arms were comparable. In the minilaparotomy group, complications were as follows: 1 case (2.4%) of delayed laparotomy with 2 units of red blood cell transfusion, 2 cases (4.8%) of wound infection, and 3 cases (7.3%) of fever of unknown origin. No minor or major complications were observed in the LAVH group. Postoperative visual analog scale pain scores at days 1 and 2 were significantly lower in the LAVH group (p <.05). The complication rate between the 2 groups was significantly lower for LAVH (p = .026).
  
  
  CONCLUSIONS
  Because LAVH was associated with significantly lower early postoperative pain scores and complication rates, in general LAVH should be preferred to minilaparotomy hysterectomy when the vaginal approach cannot be used.
authors.affiliation: Department of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy. l.muzii@unicampus.it
authors.forename: Ludovico
authors.initials: L
authors.lastname: Muzii
authors.forename: Stefano
authors.initials: S
authors.lastname: Basile
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
authors.forename: Daniela
authors.initials: D
authors.lastname: Marconi
authors.forename: Marzio Angelo
authors.initials: MA
authors.lastname: Zullo
authors.forename: Natalina
authors.initials: N
authors.lastname: Manci
authors.forename: Filippo
authors.initials: F
authors.lastname: Bellati
authors.forename: Roberto
authors.initials: R
authors.lastname: Angioli
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Benedetti Panici
mesh_terms: D000328:Adult; D000075202:Contraindications; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000601:surgery