title: Comparison of re-operation rates and complication rates after total laparoscopic hysterectomy (TLH) and laparoscopy-assisted supracervical hysterectomy (LASH).
abstract: OBJECTIVE
  To compare re-operation rates and complication rates after total laparoscopic hysterectomy (TLH) and laparoscopy-assisted supracervical hysterectomy (LASH).
  
  
  METHODS
  Retrospective analysis of 867 women who underwent laparoscopic hysterectomy between January 2002 and December 2009 for benign gynaecological diseases. Total laparoscopic hysterectomy was performed in 567 women (TLH group) and laparoscopy-assisted supracervical hysterectomy was performed in 300 women (LASH group).
  
  
  RESULTS
  The women in the LASH group were significantly younger (45.6 years) than those in the TLH group (47.9 years) and the uteri removed with LASH were significantly heavier (326.4 g) than those removed with TLH (242.7 g). The rate of salpingo-oophorectomy was significantly lower in the LASH group. The overall re-operation rates were equivalent in the two groups. Two method-specific reasons for re-operations were identified. A method-specific procedure after LASH was extirpation of the cervical stump, which was performed in 2.7% of the women. Vaginal cuff dehiscence was a method-specific problem leading to secondary operation after TLH and was observed in 0.7% of the patients. No differences between the intraoperative and postoperative complication rates were observed, although there was a trend toward lower complication rates after LASH.
  
  
  CONCLUSIONS
  There seem to be equivalent overall re-operation rates and complication rates after both hysterectomy procedures, making the two laparoscopic approaches for hysterectomy equivalent.
authors.affiliation: Department of Obstetrics and Gynaecology, Erlangen University Hospital, University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054 Erlangen, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Boosz
authors.forename: Johannes
authors.initials: J
authors.lastname: Lermann
authors.forename: Grit
authors.initials: G
authors.lastname: Mehlhorn
authors.forename: Christian
authors.initials: C
authors.lastname: Loehberg
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Renner
authors.forename: Falk C
authors.initials: FC
authors.lastname: Thiel
authors.forename: Michael
authors.initials: M
authors.lastname: Schrauder
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Mueller
mesh_terms: D000328:Adult; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies