A case control study to compare laparoscopically assisted vaginal hysterectomy and total abdominal hysterectomy.

ABSTRACT

Background: Laparoscopic Assisted Vaginal Hysterectomy (LAVH) has become increasingly popular as a definite alternative to abdominal hysterectomy. Objective: To compare operative outcomes of laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH). Study design: Retrospective case control study. Materials and Methods: Data from medical records of 29 cases and 29 controls were reviewed and recorded. Study design: Retrospective case control study. Setting: A tertiary care hospital at Bareilly (UP). Subjects: Twenty nine patients who underwent LAVH between 01 October 2010 and 30 September 2011 were recruited as cases and controls were 29 patients, who underwent TAH during the same period. Inclusion criteria were that patients be matched in a case control manner for age, weight, diagnosis, and uterine size. Results: Basic characteristics such as age, parity, weight and uterine size of cases and controls were comparable. Mean operative time was 139±11 minutes for LAVH group which was significantly longer than 99±9 minutes for TAH group. Mean blood loss during surgery in LAVH group of patients was 250ml and it was 275 in abdominal hysterectomy patients, however observed differences were not significant. Mean Hb drop after 24 Hrs of surgery was 1.4g/dl in LAVH group and it was 1.6g/dl in TAH group and differences was not significant. Number of doses of injectable analgesics used per patients was significantly more in TAH group (2.3) in comparison to LAVH (1.2). Overall complication was 14% in LAVH and 10% in TAH and differences were not significant. The mean hospitalization was significantly shorter for LAVH group 2.7 days compared to 5.5 days in TAH group. Conclusion: LAVH had longer operative time but with shorter hospital stay in comparison with TAH.