Comparison of total laparoscopic hysterectomy (TLH) and laparoscopy-assisted supracervical hysterectomy (LASH) in women with uterine leiomyoma.
OBJECTIVE
To compare total laparoscopic hysterectomy (TLH) using the Hohl instrument with laparoscopy-assisted supracervical hysterectomy (LASH) in women with uterine leiomyoma.


METHODS
231 women underwent laparoscopic hysterectomy for the treatment of symptomatic leiomyoma between January 2005 and December 2007. A total of 113 women decided to undergo complete hysterectomy with removal of the cervix (TLH group) and 118 women wished to preserve the cervix; LASH was carried out in the latter group (LASH group).


RESULTS
No ureteral or bladder injury occurred in any of the patients. Two intraoperative complications and one postoperative complication occurred in the TLH group, while no complications occurred in the LASH group. When the TLH group was compared with the LASH group, the mean loss of hemoglobin was 1.6+/-1.1g/dL (95% CI 1.4-1.8) vs. 1.5+/-1.4g/dL (95% CI 1.2-1.7); the mean operating time was 114.0+/-33.8min (95% CI 107.6-120.2) vs. 116.5+/-40min (95% CI 109.3-124.0); and the mean uterus weight was 264.8+/-133.6g (95% CI 239.8-289.6) vs. 286.2+/-209.3g (95% CI 247.4-324.4). Hospital stay and use of analgesia in both groups were equal. No statistically significant differences were found.


CONCLUSIONS
TLH using the Hohl instrument is an option comparable with laparoscopy-assisted supracervical hysterectomy for women with uterine leiomyoma. However, the complication rates may be lower when LASH is performed.
Mueller
Andreas
A
Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen-Nuremberg, Germany. andreas.mueller@uk-erlangen.de
Renner
Stefan P
SP
Haeberle
Lothar
L
Lermann
Johannes
J
Oppelt
Peter
P
Beckmann
Matthias W
MW
Thiel
Falk
F
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D014594:Uterine Neoplasms / Q000601:surgery*