A Comparative Study of Total Lapaproscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH) / 대한산부인과학회지

OBJECTIVE: To compare the clinical results between total laparoscopic Hysterectomy (TLH) and total abdominal hysterectomy (TAH). METHODS: 100 cases of TLH and 95 cases of TAH, which were performed at Pocheon CHA university from January 2001 to September 2004. We analyzed the results with regard to patient's characteristics (age, parity), uterine weight, operative time, blood loss, hospital stay and complications. RESULTS: There were no differences in terms of patient's age, parity, main operative indication and total operating time between the 2 groups. The mean uterine weight of TAH group was larger than TLH (291 +/- 239 gm for TLH, 404 +/- 174 gm for TAH, p<.05) group. The estimated blood loss was significantly lower for TLH (239.00 +/- 155.63 mL) than for TAH (333.68 +/- 228.4 mL) (p<.05). The length of hospital day was significantly shorter for TLH (6.78 +/- 1.70 day) than for TAH (7.39 +/- 1.49 day) (p<.05). Post-operative complications in the TLH group were dysuria in 2 cases, major hemorrhage requiring transfusion in 4 cases, trocar site hematoma in 1 case and bowel injury in 1 case. Post-operative complications In the TAH group were major hemorrhage requiring transfusion in 7 cases, wound infection in 3 cases and bowel injury in one case. CONCLUSION: The present study demonstrates that, given adequate training in laparoscopic surgery, TLH may replace TAH in most patients who require a hysterectomy, showing clear advantages of shorter hospitalization and the acceptable complication rate.

Laparoscopic Hysterectomy for Large Uterus:A Report of 86 Cases / 中国微创外科杂志

Objective To investigate the operative skills of laparoscopic hysterectomy of large uterus.Methods A retrospective analysis was conducted on clinical data from 86 cases whose uterus were bigger than twelve gestational age uterus and therefore treated with laparoscopic hysterectomy from February 1998 to December 2005.Among the 86 cases,12 received total laparoscopic hysterectomy(TLH),59 received laparoscopic supracervical hysterectomy(LSH),and 15 received laparoscopic-assisted vaginal hysterectomy(LAVH).The location of laparoscopy was determined to be at least 3-5 cm above the fundus of uterus.The most crucial step was the treatment of adnexa and uterine blood vessels.After blocking the uterine blood vessels,most of uterine bodies were rotarily cut in TLH and LAVH.Results All operations(86 cases)were performed successfully under laparoscopy and no severe operative complications were noticed except for 1 case of subcutaneous emphysema.The average operation time and the intra-operative blood loss were(92.3 ?33.5)min and(113 ?31)ml respectively.The average postoperative hospital stay was(4.1?0.3)days.No postoperative complication was found in all cases during the 6-month follow-up.Conclusions Laparoscopic hysterectomy of large uterus is safe and feasible,and does not increase operative risk and incidence of complications,when suitable laparoscopic location is selected and treatments of adnexa and uterine vessel are well performed.