Comparison of vaginal and abdominal hysterectomy: a prospective non-randomized trial

The present study examined outcomes of patients who underwent vaginal hysterectomy or abdominal hysterectomy at the Department of Obstetrics and Gynaecology, Air Force General Hospital, PLA, Beijing, China

Bing Chen

2014

Scholarcy highlights

  • Hysterectomy is currently one of the most common gynaecological surgical procedures. In the United States, hysterectomy is second to Caesarean delivery as the most frequently1
  • The present study examined outcomes of patients who underwent vaginal hysterectomy or abdominal hysterectomy at the Department of Obstetrics and Gynaecology, Air Force General Hospital, PLA, Beijing, China
  • Fewer febrile episodes or unspecified infection and shorter operation time were noticed in LAVH procedures compared with total laparoscopic hysterectomy procedures
  • Operation time and bleeding are increased in TLH as compared with LAVH
  • TLH is associated with greater safety, efficacy, and improvement in the patient quality of life compared to total AH in women with benign gynaecological diseases
  • VH was performed in patients with uterine size equivalent to 8-16 weeks, and was associated with less operation time, less intraoperative blood loss and better postoperative outcomes compared with AH, suggesting that VH is an effective treatment for patients with benign gynaecological diseases
  • Mistrangelo et al reported that vaginal hysterectomy was safe and effective in cases of greater uterine weight or volume. Guvenal et al found that VH could be performed with less morbidity, even in patients with a large, immobile uterus and previous pelvic surgery. Falcone et al have confirmed the success of the vaginal approach in patients with these characteristics. Rates of urethral and bladder injuries at the time of VH were 0.88% and 1.76%, respectively. Consistent with this, in a recent large case series, the incidence of bowel injury was low in VH patients. conversion rates from the vaginal to abdominal approach have been reported to be of 0.4% in a retrospective review of 220 patients. In this study, no intraoperative complications occurred in patients of the VH group, and no vaginal approach was converted to an abdominal approach

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