title: [Surgical approaches to hysterectomy].
abstract: OBJECTIVE
  this study aims to assess the frequency, complications and advantages of each of the three principal approaches to hysterectomies: abdominal, vaginal, and laparoscopic.
  
  
  METHODS
  this prospective study analyses a consecutive series of 78 hysterectomies for benign disease (myomas and precancerous lesions of the cervix) in the gynaecological surgery department of Libreville Hospital Centre from March 1, 2006, to November, 2010. We excluded cases of genital prolapsus, invasive uterine cancer, and hysterectomy during pregnancy or delivery. Data were collected from the surgical registers and reports and from patients' files.
  
  
  RESULTS
  the frequency of abdominal hysterectomy was about 39% (31 cases), and that of vaginal hysterectomy 61% (31 cases); laparoscopic assistance was involved in 20.58% (14 cases). The women's mean age was 46  years (range: 45 to 60  years). Mean parity was 5.5 (range: 0 to 9). Overall, 30% of the patients had previously undergone pelvic surgery by the abdominal route. Two wounds, one of the bladder and the other of the uterus, comprised the surgical morbidity. No deaths occurred.
  
  
  CONCLUSIONS
  the surgeon's experience with the vaginal route, sometimes with laparoscopic assistance, resulted in limited use of the abdominal route.
authors: Hôpital d'instruction des armées Omar Bongo Ondimba, Service de chirurgie gynécologique, BP 13748 Libreville, Gabon. pitherserge@lnet.ga
authors: Serge
authors: S
authors: Pither
authors: L S
authors: LS
authors: Bayonne Manou
authors: J M
authors: JM
authors: Mandji Lawson
authors: T D D
authors: TD
authors: Tchantchou
authors: R
authors: R
authors: Tchoua
authors: J P
authors: JP
authors: Ponties
mesh_terms: D005260:Female; D005681:Gabon; D006801:Humans; D007044:Hysterectomy / Q000379:methods* / Q000706:statistics & numerical data; D010535:Laparoscopy; D008875:Middle Aged; D011446:Prospective Studies