Study to analyse the intraoperative and post-operative complications of total abdominal hysterectomy and total laparoscopic hysterectomy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240794Keywords:
Intra and post-operative complications, Total abdominal hysterectomy, Total laproscopic hysterectomyAbstract
Background: Laparoscopic hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim of the study was to compare the risks and complications of total laparoscopy hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.
Methods: A retrospective observational study was conducted in the Gynaecology department at Department of Obstetrics and Gynecology, Central Railway Hospital, Jabalpur, Madhya Pradesh, India. The data for the past 2-year record was taken for analysis. A total of 72 subjects were included in the study and were divided into two groups with 36 patients under TAH (total abdominal hysterectomy) group and 36 under TLH (Total Laproscopic hysterectomy) group. The primary outcome of the present analysis were incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of post operative stay.
Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (215 ml) compared to TLH group (124 ml) and the difference was found to be statistically significant (p<0.05). Similarly, the duration of operative procedure was found to be less in TLH group (46.5 mins) compared to TAH group (76.8 mins) and the difference was found to be statistically significant (p<0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the TLH group and the difference was found to be statistically significant (p<0.05).
Conclusions: TLH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.
References
Keshavarz H, Hillis SD, Kieke BA, Marchbanks PA. Centre for Disease control (CDC) MMWR. Hysterectomy surveillance-United States, 1994-1999. Surveillance Summaries. 2002;51(SS05):1-8.
Singh AJ, Arora AK. Effect of uterine prolapse on the lines of rural North Indian women. Singapore. J Obstet Gynecol. 2003;34(2):52-8.
Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol. 1990;94(4):435-8.
Singh KC, Barman SD, Sengupta R. Choice of hysterectomy for benign disease department of obstetrics and Gynecology University college of medical sciences, Delhi. J Ohstet Gyneco lInd. 2004;54(4):365-70.
Reich H. Total Laparoscopic hysterectomy: indications techniques and outcomes. Cur Open Obstet Gynecol. 2007;19(4):337-44.
Nieboer TE, Johnson N, Barlow D. Surgical approach to hysterectomy for benign gynaecological disease. Coch Data Systemat Rev. 2009;3:3677.
Sinha R, Sundaram M, Lakhotia S, Hedge A, Kadam P. Total Laparoscopic Hysterectomy in women with Previous caesarean section. J Minim Invasive Gynecol. 2010;17(14):513-7.
Obermair A, Manolitsas TP, Leung Y, Hammond IG, McCartney AJ. Total laparoscopic hysterectomy versus total abdominal hysterectomy for obese womenwith endometrial cancer. Int J Gynecol Cancer. 2005;15(2):319-24.
Reich H. New techniques in advanced laparoscopic surgery. Baillieres Clin Obstet Gynaecol. 1989;3(3):655-81.
Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG. Hysterectomy rate in the United States. Obstet Gynecol. 2007;110(5):1091-5.
Kulvanitchaiyanunt A. A retrospective and comparative study between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH). J Med Assoc Thai. 2004;87(7):745-9.
Merrill RM. Hysterectomy surveillance in the United States, 1997 through 2005. Med Sci Monit. 2008;14(1):CR24-31.
Kluivers KB, Johnson NP, Chien P, Vierhout ME, Bongers M, Mol BW. Comparison of laparoscopic and abdominal hysterectomy in terms of quality of life: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2008;136 (1):3-8.
Komatsu H, Taniguchi F, Nagata H, Nakaso T, Nagaya Y, Tsukihara S. Retrospective evaluation of the crucial factor in total laparoscopic hysterectomy by using video review. Laparosc Surg. 2019;3(23).
Celik C, Abali R, Tasdemir N, Aksu E, Çalışkan H, Akkuş D. Total laparoscopic hysterectomy compared with abdominal hysterectomy; clinical outcomes. J Clin Anal Med. 2014;5(6):490-3.
Cho HY, Choi KJ, Lee YL, Chang KH, Kim HB, Park SH. Comparison of two bipolar systems in laparoscopic hysterectomy. JSLS. 2012;16(3):456-60.
Kongwattanakul K, Khampitak K. Comparison of laparoscopically assisted vaginal hysterectomy and abdominal hysterectomy: a randomized control led trial. J Min Inv Gynecol. 2012;19(1):89-94.
