Key result
Vaginal and laparoscopic hysterectomies linked to ~1 day shorter stays and lower blood loss vs TAH.
Why the study?
This study was conducted to compare the perioperative findings among women undergoing hysterectomy by abdominal, vaginal, and laparoscopic routes.
Do vaginal and laparoscopic hysterectomies improve perioperative outcomes compared to abdominal hysterectomy in women with benign conditions?
Cross-Sectional (n=385)
No
Do vaginal and laparoscopic hysterectomies improve perioperative outcomes compared to abdominal hysterectomy in women with benign conditions?
Absolute Event Rate: 3.9% vs 4.8%
p-value: p=<0.01
Vaginal and laparoscopic hysterectomies are associated with shorter hospital stays and lower estimated blood loss compared to abdominal hysterectomy for benign conditions.
VH and TLH linked to shorter stays and fewer complications than TAH in this observational cohort; leaves open whether findings generalize or alter practice without randomized confirmation.
Background: This study was conducted to compare the perioperative findings among women undergoing hysterectomy by abdominal (TAH), vaginal (VH) and laparoscopic (TLH) routes. Methods: A 5-year cross-sectional survey was conducted at the Aga Khan University Hospital from January 2015-December 2020 to compare perioperative outcomes of the different routes of hysterectomies. Medical record review of 385 patients who underwent hysterectomy for benign conditions were reviewed and analysed, out of which 195 (50.6%) underwent TAH, 96 (24.9%) VH and 94 (24.4%) were operated laparoscopically. Patients with uncontrolled medical comorbid, history of 2 or more abdominal surgeries and uterine size of more than 14 weeks were excluded from the study. Results: revealed significant difference between the mean hospital stay of patients with TAH having the highest mean stay in days (TAH=4.8±1.01, VH=4.4±0.7 and TLH=3.9±0.82 in days; p<0.01) TLH took comparatively significantly longer operating time than TAH (p=0.0005) and VH groups (p=0.004) however, median estimated blood loss was significantly lower in women who underwent TLH as compare to TAH [median (25th-75th percentile); 100 (50-200)] versus 300 (200-500); p<0.01] and VH [100 (50-200)] versus 250 (100-400); p<0.01]. The incidence of post-operative complications was less than 3% and these were observed in women underwent TAH. Conclusions: VH and TLH have lesser complications and hospitalization days as compared to TAH, making these 2 methods superior. Informed decision making by patient and surgeon’s training together can account for choosing the best method of hysterectomy suitable to the patient.
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Rehman et al. (2023) conducted a cross-sectional in Benign uterine conditions requiring hysterectomy (n=385). Vaginal and laparoscopic hysterectomy vs. Total abdominal hysterectomy (TAH) was evaluated on Mean length of hospital stay (days) (p=<0.01). Vaginal and total laparoscopic hysterectomies were associated with significantly shorter hospital stays and lower estimated blood loss compared to total abdominal hysterectomy.
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