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Laparoscopic-Assisted Vaginal Hysterectomy vs Laparoscopic Supracervical Hysterectomy for Treatment of Nonprolapsed Uterus

      Abstract

      Study Objective

      To compare perioperative outcomes between laparoscopic-assisted vaginal hysterectomy (LAVH) and laparoscopic supracervical hysterectomy (LSH) for the nonprolapsed uterus.

      Design

      Retrospective chart analysis (Canadian Task Force classification II-2).

      Setting

      Three university-affiliated community hospitals.

      Patients

      Women undergoing LAVH or LSH because of benign indications without concomitant pelvic organ prolapse.

      Intervention

      Laparoscopic hysterectomy with or without adnexectomy.

      Measurements and Main Results

      Data from 265 LAVH procedures and 181 LSH procedures performed at 3 university-affiliated community hospitals were included in the analysis from January 2001 to December 2007. The cases were successive. Exclusion criteria included surgery performed to treat malignancy or pelvic organ prolapse, and procedures that were converted to laparotomy. Two hundred forty-eight LAVH procedures and 173 LSH procedures were completed successfully. There was no significant difference in mean (SD) operating time between the 2 groups (145.1 [45.6] minutes for LAVH vs 143 [51.7] minutes for LSH; p = .66). Hospital stay was significantly shorter in the LSH group (1.6 [0.6] days vs 1.2 [0.5] days; p = .001). Patients in the LAVH group had significantly larger uterine weight (147.7 [84.8] g vs 121.5 [105.5] g; p = .005). Postoperative hemoglobin change and febrile morbidity were similar between the groups, as were overall perioperative complications (19% vs 15%, respectively; p = .36) and conversion rate to laparotomy (6.9% vs 4.6%; p = .27).

      Conclusion

      Compared with LAVH, LSH offers the benefits of a shorter hospital stay when performed in patients without uterine prolapse. Other perioperative outcomes studied were not significantly different between groups.

      Keywords

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