Clinical comparisons of laparoscopically assisted vaginal hysterectomy and total vaginal hysterectomy / 대한산부인과학회지

ABSTRACT

OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total vaginal hysterectomy (TVH). METHODS: We reviewed the medical records of patients who underwent LAVH and TVH from January 2002 to December 2004 in 00 university hospital without the history of uterine prolapse or pelvic relaxation. We evaluated age, parity, previous abdominal operations, indication of hysterectomy, size of the uterus, operation time, hemoglobin change, hospital day, the degree of postoperative pain and initiation of diet and postoperative complications. RESULTS: The age and parity of the patients in both groups were not different statistically. There were history of previous abdominal operations in 20.8% of LAVH group and 25.3% of TVH group which didn't have statistic significance. Major indications of the operation were uterine myomas in both groups. The average weight of the extracted uterus were 272.9+/-114.5 gm and 225.6+/-87.0 gm in the LAVH group and the TVH group respectively which had significance, and the operation time were 81.1+/-23.4 minutes and 71.1+/-37.8 minutes respectively which had significance. There were no difference in the hemoglobin drop of the postoperative day 1, but the hemoglobin drop of the postoperative day 4 was larger in the LAVH group. Postoperative complications occurred more often in the TVH group (15.2%) than LAVH group (11.9%) but didn't have significance, and the complications were treated by conservative managements and observation of the progress. And also the hospital day, the degree of postoperative pain and initiation of diet had no significance. CONCLUSION: Both LAVH and TVH had no statistic difference in the postoperative morbidity and recuperation. Moreover the indications of operation for both surgeries had no statistic difference, but LAVH had a preference for the larger size of uterus. Furthermore in order to increase the satisfactions of patients and remedy the weak points of procedures, research on the indications and contra-indications between the operative approaches and training on the operative procedures are required.