title: Abdominal, vaginal and total laparoscopic hysterectomy: perioperative morbidity.
abstract: OBJECTIVE
  The aim of our retrospective study was to assess and to compare the surgical complications of hysterectomy regarding the choice of procedure [abdominal (AH), vaginal (VH), and total laparoscopic hysterectomy (TLH)].
  
  
  METHODS
  A total of 6,480 patient charts undergone hysterectomy were retrospectively analyzed. Data including transfusion, bladder, ureteral and bowel injury, cuff dehiscence, pulmoner embolus, febrile morbidity, hematoma, reoperation, pelvic wall problems were gathered. The Chi-square test and Student's t test were used in the statistical analysis.
  
  
  RESULTS
  The most common perioperative complication was blood transfusion which occurred in 114 patients (2.6%). VH patients required significantly less blood transfusion than AH (2.1, 2.6%, respectively). AH had significantly more bladder injury than VH (0.7, 0.4%, respectively). AH had significantly more ureteral injury than VH (0.2, 0.1%, respectively). AH had the same bowel injury as VH (0.1%). AH and VH necessitated significantly more reoperation than TLH (0.4, 0.2, 0.0%, respectively).
  
  
  CONCLUSIONS
  To our study, VH ensures less complication rates than AH. In experienced centers, VH can be a reliable alternative to AH. Controlled prospective studies with large patient volumes are required to compare TLH and VH according to complication rates.
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Mother Health Training and Research Hospital, Ankara, Turkey. drmdoganay@gmail.com
authors.forename: Melike
authors.initials: M
authors.lastname: Doğanay
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Yildiz
authors.forename: Esra
authors.initials: E
authors.lastname: Tonguc
authors.forename: Turgut
authors.initials: T
authors.lastname: Var
authors.forename: Rana
authors.initials: R
authors.lastname: Karayalcin
authors.forename: Ozlem Gun
authors.initials: OG
authors.lastname: Eryılmaz
authors.forename: Orhan
authors.initials: O
authors.lastname: Aksakal
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries; D001743:Urinary Bladder / Q000293:injuries