Abdominal, vaginal and total laparoscopic hysterectomy: perioperative morbidity.
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.
Doğanay
Melike
M
Department of Obstetrics and Gynecology, Zekai Tahir Burak Mother Health Training and Research Hospital, Ankara, Turkey. drmdoganay@gmail.com
Yildiz
Yasemin
Y
Tonguc
Esra
E
Var
Turgut
T
Karayalcin
Rana
R
Eryılmaz
Ozlem Gun
OG
Aksakal
Orhan
O
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