title: Comparison of laparoscopically assisted vaginal hysterectomy and abdominal hysterectomy: a randomized controlled trial.
abstract: OBJECTIVE
  To compare intraoperative hemorrhage and other operative parameters after laparoscopically assisted vaginal hysterectomy (LAVH) versus total abdominal hysterectomy (TAH) for benign gynecologic conditions.
  
  
  METHODS
  A prospective, randomized, controlled trial.
  
  
  METHODS
  Between April 2010 and March 2011, 50 Thai patients with strong indications for hysterectomy--with uterine sizes ≤16 weeks of gravid uterus and with no contraindications for open or laparoscopic surgeries--were randomly assigned for LAVH or TAH.
  
  
  METHODS
  Intraoperative blood loss, operating time, postoperative analgesic requirements, perioperative complications, and duration of hospitalization.
  
  
  RESULTS
  Intraoperative blood loss was significantly less in the LAVH group (median 120 mL [range 50-300]) than in the TAH group (median 250 mL [105-800]) (median difference 130 mL, p <.001, 95% confidence interval [CI] 55-200). The LAVH group required significantly less postoperative morphine sulfate administration (median 3 mg [range 0-12]) than the TAH group (15 mg [6-24]) (median difference 9 mg, p <.001, 95% CI 9-12). The hospital stay for the LAVH group (median 3 days; range 2-7) was significantly shorter than that of the TAH group (median 4 days; range 4-5) (median difference 2 days, p <.001, 95% CI 1-2). The operating time was comparable between the 2 groups (median 100 minutes; range 50-240) for the LAVH and 115 minutes (range 60-200) for the TAH group (median difference 5 minutes, p =.592, 95% CI -15-25). There were no conversions from a LAVH to a laparotomy.
  
  
  CONCLUSIONS
  The LAVH has advantages over the TAH in that in the former there is less intraoperative blood loss, less postoperative morphine requirement, and a shorter duration of postoperative hospital stays.
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors: Kiattisak
authors: K
authors: Kongwattanakul
authors: Kovit
authors: K
authors: Khampitak
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D016063:Blood Loss, Surgical; D001810:Blood Volume; 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; D009020:Morphine / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine