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. 2016 Oct;66(Suppl 1):389-94.
doi: 10.1007/s13224-015-0756-z. Epub 2015 Sep 1.

A Prospective Randomized Comparative Study of Vaginal, Abdominal, and Laparoscopic Hysterectomies

Anand Murari Nanavati  1 , Sudhir B Gokral  2
Affiliations

A Prospective Randomized Comparative Study of Vaginal, Abdominal, and Laparoscopic Hysterectomies

Anand Murari Nanavati et al. J Obstet Gynaecol India. 2016 Oct.

Abstract

Purpose: The present study is a prospective, randomized comparative study of abdominal, vaginal and laparoscopic hysterectomies comparing various parameters such as indications, blood loss, post operative pain, time taken for surgery, intraoperative and postoperative complications and total hospital stay.

Materials and methods: 50 patients were selected in each group over a period of 18 months. The patients were selected in such a way that they could be operated by all 3 routes. Thus patients undergoing hysterectomy for non malignant conditions, having no adnexal masses, having no severe endometriosis, uterine size not more than 12 weeks and uterine descent of not more than 1st degree were selected.

Results: The most common indication for hysterectomy was found to be DUB, the maximum time taken was in TLH, the minimum blood loss was found in TLH. There was significant difference in the pain scores using VAS among the three groups on day 0 and day 1, where the scores were significantly lower in VH group, the hospital stay was maximum in TAH group while there was no difference between VH and TLH groups.

Conclusion: TLH is a better alternative for TAH and with good equipment, expertise and excellent teamwork TLH will be the future candidate for mode of surgery.

Keywords: Abdominal hysterectomy; Laparoscopic hysterectomy; Vaginal hysterectomy.

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Conflict of interest statement

Anand Murari Nanavati and Sudhir Gokral declare that they have no conflict of interest. Informed consent in studies with human studies All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all patients being included in this study.

Figures

Chart 1
Chart 1
Total time for surgery. The average time taken for total laparoscopic hysterectomy was 108 min, time taken for abdominal hysterectomy was 75 min, and time taken for vaginal hysterectomy was 77.50 min
Chart 2
Chart 2
Blood loss. The average blood loss for total laparoscopic hysterectomy was the least
Chart 3
Chart 3
Pain score on vas scale. Postop pain on VAS scale was the maximum in total abdominal hysterectomy on all the days postsurgery. There is no significant difference between the VAS score in patients undergoing vaginal and total laparoscopic hysterectomies on day 2 and day 3 postsurgery
Chart 4
Chart 4
Total hospital stay. The total hospital stay was maximum in TAH group with average stay of 6 days. There was no significant difference in hospital stay between VH and TLH groups
See this image and copyright information in PMC

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