title: A comparison of vaginal, laparoscopic-assisted vaginal, and minilaparotomy hysterectomies for enlarged myomatous uteri.
abstract: OBJECTIVE
  To compare the operative data and early postoperative outcome of vaginal hysterectomy (VH), laparoscopic-assisted vaginal hysterectomy (LAVH), and minilaparotomy hysterectomy (MiniLPT).
  
  
  METHODS
  A total of 150 women who required hysterectomy for enlarged myomatous uteri were randomly allocated into 3 treatment groups: VH (n=50), LAVH (n=50), and MiniLPT (n=50). The primary outcome was hospital discharge time. The secondary outcomes were operative time, blood loss, paralytic ileus, postoperative pain, and intraoperative and early postoperative complications.
  
  
  RESULTS
  Mean hospital discharge time was longest with MiniLPT, and shortest with VH (P<0.01). VH was the fastest operating technique, was associated with less blood loss, and resulted in shortest duration of paralytic ileus (P<0.01). No intraoperative complications occurred.
  
  
  CONCLUSIONS
  VH should be the preferred surgical approach in patients with enlarged myomatous uteri. When VH is not feasible, LAVH should be considered an alternative to MiniLPT. Further controlled prospective studies are required to confirm these results.
authors.affiliation: Section of Gynecology and Obstetrics, School of Medicine, Tor Vergata University Hospital, Rome, Italy. Francesco.Sesti@uniroma2.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Sesti
authors.forename: Francesca
authors.initials: F
authors.lastname: Calonzi
authors.forename: Velia
authors.initials: V
authors.lastname: Ruggeri
authors.forename: Adalgisa
authors.initials: A
authors.lastname: Pietropolli
authors.forename: Emilio
authors.initials: E
authors.lastname: Piccione
mesh_terms: D000704:Analysis of Variance; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D007902:Length of Stay; D008875:Middle Aged; D009214:Myoma / Q000601:surgery*; D011183:Postoperative Complications; D014594:Uterine Neoplasms / Q000601:surgery*; D014621:Vagina / Q000601:surgery