A comparative study between total laparoscopic hysterectomy and total abdominal hysterectomy for benign uterine conditions

Authors

  • Shakuntla Department Obstetrics and Gynaecology, SMS Medical College, Jaipur, Rajasthan, India
  • Oby Nagar Department Obstetrics and Gynaecology, SMS Medical College, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20233636

Keywords:

TLH, TAH, Benign uterine conditions

Abstract

Background: The aim of this prospective study is to evaluate and compare the results of two routes of hysterectomy for benign uterine conditions of less than 14 weeks who performed in our tertiary centre.

Methods: This was a prospective interventional single centre study on 140 consecutive patients (70 patients in each group) who underwent hysterectomy for benign uterine conditions either by total laparoscopic hysterectomy (TLH) or by total abdominal hysterectomy (TAH) route.

Results: There were no statistical differences between two groups regarding age, parity, previous history of abdominal surgery, demographic factors, For TLH group vs. TAH group- operative time was (89.34±12.3 minutes) vs. (46.6±5.92 minutes) (p<0.0001), blood loss (19.61±2.34 ml) vs. (124.8±17.29 ml) (p<0.0001), post operative haemoglobin drop (0.34±0.15 gm/dl) vs. (1.36±0.24 gm/dl) (p<0.0001), pain score (2.56±0.97) vs. (5.31±1.02) (p<0.0001), mean ambulation time (15.16 ± 4.64 hours) vs. (48.76±5.08 hours) (p<0.0001), mean time to catheter removal (12.47±0.94 hours) vs. (48.23±0.64 hours) (p<0.0001), hospital stay (3.74±0.50 days) vs. (7.64±0.98 days) (p<0.0001), resumption to normal daily activities (4.39±0.2 weeks) vs. (11.8±1.77 weeks) (p<0.0001), were significantly lower and earlier in TLH group as compared to TAH group, also compared intra-operative and post-op complication (less in TLH group) and patient satisfaction score(better in TLH group).

Conclusions: TLH route is safe and feasible as compare to TAH route and found to have, less amount of blood loss, fewer complications and early ambulation, recovery and discharge.

 

References

Dogra A, Kumar V, Bhushan N. TLH versus TAH: a 2 year retrospective comparative study. Int J Reprod Contracept Obstetric Gynecol. 2019;8:3939-42.

Naveen RMV, Rupa RM. Comparison of total abdominal, vaginal and total laparoscopic Hysterectomy. Int Surg J. 2016;3(4):2007-11.

Shrestha R, Yu LH. Comparison between Laparoscopic Hysterectomy and Abdominal Hysterectomy NJOG. 2014;9(17):sh20.

Chanil E, Arunasalam P, Sanjeewa K, Rasika H, Prasantha W. Cost evaluation, quality of life and pelvic organ function of three approaches to hysterectomy for benign uterine conditions: study protocol for a randomized controlled trial. Trials. 2017;18:565.

Kanmani M, Mirudhubashini G, Vishranthi S. Comparative study of surgical results between total abdominal hysterectomy and total laparoscopic hysterectomy in a tertiary hospital: a 2 year retrospective study. Int J Reproduct Contracept Obstetr Gynecol. 2018;7(3):1019-23.

Sutasanasuang S. Laparoscopic hysterectomy versus total abdominal hysterectomy: a retrospective comparative study. J Med Assoc Thai. 2011;94(1):8-16.

Sridhar M, Chillamherla S. Comparison of open abdominal hysterectomy and total laparoscopic hysterectomy: a study in a teaching hospital. Int Surg J. 2016;3(1):296-300(17).

Tamrakar SR A Comparative Study of Surgical Outcome In Different Approaches For Hysterectomy JNGMC. 2019;17.

Nanavati AM, Gokral SB. A Prospective Randomized Comparative Study of Vaginal, Abdominal, and Laparoscopic Hysterectomies. J Obstetr Gynecol India. 2016;66(S1):S389.

Rensis Likert. A Technique for the Measurement of Attitudes. Arch Psychol. 1932;140:5.

Aabd EI ST, Fawzy AMA, Youssry ME, Nour H. A comparative study of laparoscopic hysterectomy versus total abdominal hysterectomy. Bull Alex Fac Med. 2001;37(3):355-62.

Loh FH, Koa RC. Laparoscopic hysterectomy versus abdominal hysterectomy: a controlled study of clinical and functional outcomes. Singapore Med J. 2002;43(8);403-7.

Persson P, Wijma K, Hammar M, Kjølhede P. Psychological wellbeing after laparoscopi and abdominal hysterectomy-a randomised controlled multicentre study. BJOG. 2006;113:1023-30.

Kirsten B. Kluivers, MD, Jan CM. Hendriks Quality of life and surgical outcome after total laparoscopic hysterectomy versus total abdominal hysterectomy for benign disease: A randomized, controlled trial. J Minimally Invasive Gynecol. 2007;14:145-52.

Christian S. Comparison of total laparoscopic, vaginal and abdominal Hysterectomy. Arch Gynecol Obstet. 2008;277:331-7.

Walsh CA, Walsh SR, Tang TY, Slack M. Total abdominal hysterectomy versus total laparoscopic hysterectomy for benign disease: a meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2009;144(1):3-7.

Donnez O, Jadoul P, Squifflet J, Donnez J. A series of 3190 laparoscopic hysterectomies for benign disease from 1990 to 2006: evaluation of complications compared with vaginal and abdominal procedures. BJOG. 2009;116(4):492-500.

Andreas Müller, Falk C. Thiel, Stefan P. Renner, Mathias Winkler, Lothar Häberle, Matthias W. Beckmann Hysterectomy-A Comparison of Approaches. Dtsch Arztebl Int. 2010;107(20):353-9.

Theodoor EN, Jan CMH, Marlies YB, Mark EV, Kirsten BK. Quality of Life After Laparoscopic and Abdominal Hysterectomy a Randomized Controlled Trial. Obstet Gynecol. 2012;119(1):85-91.

Osman B. Comparison of total laparoscopic hysterectomy and abdominal Hysterectomy. J Turk Soc Obstet Gynecol. 2014;4:224-7.

Cem C, Remzi A, Nicel T, Erson A, Hatice Ç, Didem A. Outcomes Total Laparoscopic Hysterectomy Compared with Abdominal Hysterectomy. Turk J Obstet Gynecol. 2014;11(4):224-7.

Aarts JWM, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BWJ et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Systematic Rev. 2015;8:CD003677.

Poonam A, Neeta B, Reena Y. Risks and Benefits of Total Laparoscopic Hysterectomy and the Effect of Learning Curve on Them. J Obstetr Gynecol India. 2016;66(5):379-38.

Mallick R, English J, Waters N. Total Laparoscopic Hysterectomy versus Total Abdominal Hysterectomy in the Treatment of Benign Gynaecological Disease: A Retrospective Review Over 5 Years. Obstet Gynecol Int J. 2016;5(7):00186.

Emrah B, Abdurrahman Hİ, Volkan E, Adnan B, Sadettin OT, Ahkam GK. Comparison of the Effects of Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy on Sexual Function and Quality of Life. BioMed Res Int. 2020;8247207:6.

Mahmoud EA, Fouad C, Abdelbaset FM. Laparoscopic hysterectomy versus total abdominal hysterectomy: a retrospective study at a tertiary hospital. Gynecological Surg. 2020;17.

Ghosh D, Wipplinger P, Byrne DL. Can total laparoscopic hysterectomy replace total abdominal hysterectomy? A 5-year prospective cohort study of a single surgeon's experience in an unselected population. Gynecol Surg. 2013;10:109-15.

Melike D, Yasemin Y, Esra T, Turgut V, Rana K, Ozlem GE, Orhan AA. Vaginal and total laparoscopic hysterectomy: perioperative morbidity. Arch Gynecol Obstet. 2011;284:385-9.

Vanessa LJ. Nationwide Use of Laparoscopic Hysterectomy Compared with Abdominal and Vaginal Approaches Obstet Gynecol. 2009;114(5):1041-8.

Jain N, Kamra J, Chabbra A. Rising Trend of Laparoscopic Hysterectomy Over Abdominal Hysterectomy. A Comparative Study. World J Lap Surg. 2018;11(12):59-63.

Vaisbuch E, Goldchmit C, Ofer D, Agmon A, Hagay Z. Laparoscopic hysterectomy versus total abdominal hysterectomy: a comparative study. Eur J Obstet Gynecol Reprod Biol. 2006;126(2):234-8.

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Published

2023-11-28

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Original Research Articles