title: Peritoneal closure during laparoscopic supracervical hysterectomy.
abstract: Our goal was to compare postoperative pain and analgesic requirements regarding closure and non-closure of the peritoneum in women undergoing laparoscopic supracervical hysterectomy (LSH).
  
  
  
  A prospective cohort study was designed to investigate the impact of peritoneal closure for LSH. Postoperative pain was measured by a visual analogue scale (VAS) and analgesic requirements were assessed. Intra- and postoperative complications and operative time were recorded.
  
  
  
  A total of 104 patients were enrolled. Fifty-two (50 %) women underwent a LSH with peritoneal closure and 52 (50 %) underwent LSH without closure. The baseline characteristics were well balanced between the groups except for age; women undergoing LSH without peritoneal closure were significantly younger (p < 0.008, t test). The median operative time was 53 (26-105) minutes for LSH with peritoneal closure and 44 (24-83) minutes for LSH without peritoneal closure, a median reduction of 9 minutes (p = 0.007). No differences were found in uterine weight, intra- and post-operative complications, median haemoglobin drop or time in hospital when contrasting both groups. Both groups had similar VAS-pain scores and needed similar analgesic therapies.
  
  
  
  The peritoneal closure at LSH provides no short-term postoperative advantages over a non-closure approach, and it prolongs the operative time and anaesthetic exposure. Our data suggest that peritoneal closure is not necessary in LSH.
authors.affiliation: Department of Obstetrics and Gynecology, University Clinic Magdeburg, Germany, Gerhart-Hauptmann Str. 35, 39108, Magdeburg, Germany. holm.eggemann@med.ovgu.de.
authors.forename: Holm
authors.initials: H
authors.lastname: Eggemann
authors.affiliation: Krüssmannklinik, Munich, Germany.
authors.forename: Nara Asbahr
authors.initials: NA
authors.lastname: Mitrik
authors.affiliation: Krüssmannklinik, Munich, Germany.
authors.forename: Otto
authors.initials: O
authors.lastname: Kabdebo
authors.affiliation: Department of Obstetrics and Gynecology, University Clinic Magdeburg, Germany, Gerhart-Hauptmann Str. 35, 39108, Magdeburg, Germany.
authors.forename: Serban Dan
authors.initials: SD
authors.lastname: Costa
authors.affiliation: Department of Obstetrics and Gynecology, University Clinic Magdeburg, Germany, Gerhart-Hauptmann Str. 35, 39108, Magdeburg, Germany.
authors.forename: Atanas
authors.initials: A
authors.lastname: Ignatov
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000628:therapy*; D010537:Peritoneum / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies
keywords: Hysterectomy; Laparoscopic supracervical hysterectomy; Peritoneal closure