Hysterectomy-a comparison of approaches.
BACKGROUND
The advantages and disadvantages of the various surgical techniques for hysterectomy are currently a topic of debate, with particular controversy over leaving the cervix in situ in the laparoscopic supracervical hysterectomy (LASH) procedure.


METHODS
In a retrospective single-center study, medical history and clinical characteristics were compared in patients who had undergone hysterectomy for benign disease in the period 2002-2008 at the Department of Obstetrics and Gynecology, Erlangen University Hospital. Postoperative satisfaction and the frequency of secondary operations for prolapse or incontinence in women with surgery between 2002 and 2007 were surveyed by means of a questionnaire.


RESULTS
The longest hospital stay was observed after abdominal hysterectomy (AH; 10 days), followed by vaginal hysterectomy (VH; 7.8 days) and laparoscopy-assisted vaginal hysterectomy (LAVH; 7.2 days). The shortest stays in hospital were seen after LASH (5.9 days) and total laparoscopic hysterectomy (TLH; 5.7 days). The shortest operating time was noted with VH (87 min) and the longest with LAVH (122 min). The lowest rates of blood loss were with LASH (1.38 g/dL) and TLH (1.51 g/dL). The highest rate of postoperative complications occurred after AH (8.9%). No differences were found in relation to postoperative satisfaction or surgery for prolapse or incontinence.


CONCLUSIONS
No postoperative benefits were found for leaving the cervix in situ when performing LASH. However, this was not a controlled randomized study.
Müller
Andreas
A
Frauenklinik, Universitätsklinikum Erlangen. andreas.mueller@uk-erlangen.de <andreas.mueller@uk-erlangen.de>
Thiel
Falk C
FC
Renner
Stefan P
SP
Winkler
Mathias
M
Häberle
Lothar
L
Beckmann
Matthias W
MW
D000328:Adult; D016063:Blood Loss, Surgical; D002584:Cervix Uteri / Q000601:surgery; D005260:Female; D005858:Germany; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology*; D012086:Reoperation; D012189:Retrospective Studies; D014549:Urinary Incontinence / Q000209:etiology* / Q000601:surgery; D014596:Uterine Prolapse / Q000209:etiology* / Q000601:surgery