Minilaparotomy vs. laparoscopic hysterectomy: comparison of length of hospital stay.
OBJECTIVE
To compare length of hospital stay for minilaparotomy vs laparoscopic hysterectomy.


METHODS
Retrospective cohort study (Canadian Task Force classification II-2).


METHODS
Kaiser Permanente Northern California, a large integrated health care delivery system.


METHODS
Women >18 years of age undergoing laparoscopic or minilaparotomy hysterectomy because of benign indications from June 2009 through January 2010.


METHODS
Hysterectomy via minilaparotomy or laparoscopy.


RESULTS
Medical records were reviewed for outcomes of interest including length of stay and surgical and demographic data. Parametric and non-parametric analyses were used to compare the 2 groups. The study was powered to detect a difference of 8 hours in length of stay. Two hundred sixty-three cases were identified as hysterectomy via minilaparotomy (n = 100) or laparoscopy (n = 163). The laparoscopy group demonstrated a significantly shorter mean (SD) length of stay (19 [14] hours vs. 42 [20] hours; p < .001) and less blood loss (126 [140] mL vs. 241 [238] mL; p < .001). The minilaparotomy group experienced a shorter procedure time (113 [47] minutes vs. 197 [124] minutes; p < .001). There was no difference between the groups insofar as patient morbidity including intraoperative and postoperative complications, emergency visits, readmissions, or repeat operations.


CONCLUSIONS
Compared with minilaparotomy, laparoscopic hysterectomy is associated with shorter length of hospital stay, longer operating time, and no increased patient morbidity.
Department of General Internal Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California. Electronic address: Perron-BurdickM@obgyn.ucsf.edu.
Misa
M
Perron-Burdick
Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, San Francisco, California.
Amanda
A
Calhoun
Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, San Francisco, California.
Dennis
D
Idowu
Division of Research, Kaiser Permanente Northern California, San Francisco, California; Sutter Health Research, Development and Dissemination, San Francisco, California.
Alice
A
Pressman
Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, San Francisco, California.
Eve
E
Zaritsky
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000601:surgery*
Hospital stay; Hysterectomy; Laparoscopy; Laparotomy; Length of stay; Minilaparotomy