title: Laparoscopic hysterectomy versus abdominal hysterectomy for severe pelvic endometriosis.
abstract: OBJECTIVE
  To compare the surgical outcomes of laparoscopic hysterectomy (LH) versus abdominal hysterectomy (AH) in patients with severe pelvic endometriosis.
  
  
  METHODS
  A retrospective review of patients undergoing hysterectomy for endometriosis was conducted between January 2002 and December 2007. A total of 503 patients had severe pelvic endometriosis; of these, 115 patients underwent LH and 388 patients underwent AH. Surgical outcomes-including operative time, blood loss, length of hospital stay, and need for blood transfusion-were analyzed and compared between the 2 treatment groups.
  
  
  RESULTS
  Operative time was significantly longer for LH than for AH (185.1 ± 48.7 minutes and 139.9 ± 52.4 minutes, respectively; P<0.001). However, estimated volume of blood loss, length of hospital stay, and complication rates were significantly less for patients in the LH group than for those in the AH group (302.6 ± 255.1 mL versus 760.9 ± 633.2 mL [P<0.001]; 3.5 ± 1.1 days versus 6.4 ± 3.0 days [P<0.001]; and 18.3% versus 49.0% [P<0.001], respectively).
  
  
  CONCLUSIONS
  Compared with AH, LH was associated with fewer complications. LH should, therefore, be the preferred surgical option for women with severe pelvic endometriosis who require a hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Thai-German Multidisciplinary Endoscopic Training Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Amphan
authors.initials: A
authors.lastname: Chalermchockchareonkit
authors.forename: Putthawan
authors.initials: P
authors.lastname: Tekasakul
authors.forename: Pongsakdi
authors.initials: P
authors.lastname: Chaisilwattana
authors.forename: Korakot
authors.initials: K
authors.lastname: Sirimai
authors.forename: Noraziana
authors.initials: N
authors.lastname: Wahab
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome