A retrospective and comparative study between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH)

Kulvanitchaiyanunt, A.

Journal of the Medical Association of Thailand 87(7): 745-749

2004


ISSN/ISBN: 0125-2208
PMID: 15521227
Document Number: 2091
Objective : To compare the results of laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH). Design : Retrospective and comparative study. Setting : Department of Obstetrics and Gynecology, Ranong Hospital. Subjects : 26 cases of LAVH and 63 cases of TAH who were operated on from February 1996 to September 2001. Material and Method : Medical records of the patients were reviewed, by the same surgeon. The percentage and mean +/- SD data were analyzed a using chi-squared test and Fisher-Exact test to find the association. A p-value of 0.05 was regarded as significant. Evaluation of the outcomes : Operative time, estimated blood loss, parenteral analgesics, postoperative hospitalization, operative complications and operative cost. Results : The baselines characteristics of both groups were similar. The mean operative time for the LAVH group was 147.11 +/- 19.82 minutes, and 94.90 +/- 7.76 minutes for the TAH group. The mean length of postoperative hospitalization was 3.0 +/- 0.95 days for the LAVH group versus 5.7 +/- 0.81 days in the TAH group. There was no significant difference in the amount of estimated blood loss (369.23 +/- 57.00 ml in the LAVH and 33.41 +/- 51.97 ml in the TAH, p = 0.143). The LAVH group used fewer parenteral analgesics (meperidine) than the TAH group (64.42 +/- 17.56 mg versus 132.14 +/- 23.94 mg). The operative costs were 11,653.85 +/- 1111.48 baht in the LAVH group and 6424.60 +/- 555.09 baht in the TAH group. There was one bladder injury in the LAVH group but there was no complication detected in the TAH group. Conclusion : There are some advantages as well as disadvantages in LAVH, compared to TAH. However, in Thailand the situation is not yet favorable; more learning experience is needed and more time to gain more confidence that LAVH is a more beneficial surgical technique.

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A retrospective and comparative study between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH)