title: Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China.
abstract: BACKGROUND
  To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy (LH) compared with abdominal hysterectomy (AH) in case of benign gynecological disease.
  
  
  METHODS
  A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies (3,539 LH vs.1,356 AH) between 2007 and 2013 was involved. Operative time (OT), estimated blood loss (EBL), intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed.
  
  
  RESULTS
  The EBL (174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively), passing flatus (38.7±14.1 vs. 48.1±13.2 hours), days with indwelling catheter (1.5±0.6 vs. 2.2±0.8 days), use of analgesics (6.5% vs. 73.1%), intra-operative complication rate (2.4% vs. 4.1%), post-operative complication rate (2.3% vs. 5.7%), post-operative constipation (12.1% vs. 24.6%), mild and serious stress urinary incontinence (SUI) post-operative (P<0.001; P=0.014), and proportion of Female Sexual Functioning Index (FSFI) total score <26.55 post-operative (P<0.001) of the LH group were significantly less than those of AH group. There were no significant differences in OT (106.5±34.5 vs. 106.2±40.3 min) between the two groups.
  
  
  CONCLUSIONS
  LH is a safe and efficient operation for improving patients?long-term quality of life (QoL), and LH is a cost-effectiveness procedure for treating benign gynecological disease. LH is superior to AH due to reduced EBL, reduced post-operative pain and earlier passing flatus.
authors.affiliation: Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China;
authors.forename: Hongying
authors.initials: H
authors.lastname: He
authors.affiliation: Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China;
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Gynecological Oncology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China;
authors.forename: Dingyuan
authors.initials: D
authors.lastname: Zeng
authors.affiliation: Department of Gynecological and Obstetrics, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China;
authors.forename: Jiangtao
authors.initials: J
authors.lastname: Fan
authors.affiliation: Department of Gynecological and Obstetrics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530022, China;
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Gynecological and Obstetrics, The Affiliated Hospital of Guilin Medical University, Guilin 541004, China;
authors.forename: Yuan
authors.initials: Y
authors.lastname: Ye
authors.affiliation: Department of Gynecological and Obstetrics, The Maternal & Child Health Hospital, Nanning 530003, China;
authors.forename: Hua
authors.initials: H
authors.lastname: Bai
authors.affiliation: Department of Gynecological and Obstetrics, The People's Hospital of Liuzhou, Liuzhou 545006, China;
authors.forename: Yanming
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Gynecological and Obstetrics, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China;
authors.forename: Zhong
authors.initials: Z
authors.lastname: Lin
authors.affiliation: Department of Gynecological and Obstetrics, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China;
authors.forename: Zhiying
authors.initials: Z
authors.lastname: Lei
authors.affiliation: Department of Gynecological and Obstetrics, Liuzhou Maternal & Child Health Hospital, Liuzhou 545000, China;
authors.forename: Xinlin
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Gynecological and Obstetrics, The First People's Hospital of Nanning, Nanning 530000, China;
authors.forename: Lian
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Gynecological and Obstetrics, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China;
authors.forename: Jinghua
authors.initials: J
authors.lastname: Gan
authors.affiliation: Department of Gynecological and Obstetrics, The First Affiliated Hospital of Guangxi Technology University, Liuzhou 545000, China;
authors.forename: Ying
authors.initials: Y
authors.lastname: Lan
authors.affiliation: Department of Gynecological and Obstetrics, The People's Hospital of Guilin, Guilin 541002, China;
authors.forename: Xiongzhi
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Gynecological and Obstetrics, The People's Hospital of Beihai, Beihai 536100, China;
authors.forename: Danxia
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Gynecological and Obstetrics, The People's Hospital of Hechi, Hechi 546300, China;
authors.forename: Junsong
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Gynecological and Obstetrics, The People's Hospital of Baise, Baise 533000, China;
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Gynecological and Obstetrics, The First People's Hospital of Yulin, Yulin 537000, China;
authors.forename: Meiying
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Gynecological and Obstetrics, Wuzhou Worker's Hospital, Wuzhou 543001, China;
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Ren
authors.affiliation: Department of Gynecological and Obstetrics, The People's Hospital of Guigang, Guigang 537100, China;
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Gynecological and Obstetrics, The First People's Hospital of Qinzhou, Qinzhou 535001, China;
authors.forename: Mei
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Gynecological and Obstetrics, The Third People's Hospital of Liuzhou, Liuzhou 545007, China;
authors.forename: Qinmei
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Gynecological and Obstetrics, Liuzhou Tumor Hospital, Liuzhou 545000, China.
authors.forename: Fuyan
authors.initials: F
authors.lastname: Jiang
authors.affiliation: Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China;
authors.forename: Li
authors.initials: L
authors.lastname: Li
keywords: Benign gynecological disease; abdominal hysterectomy (AH); laparoscopic hysterectomy (LH); quality of life (QoL)