Comparative analysis of different laparoscopic hysterectomy procedures

Deslyn T.G. Hobson, Anthony N. Imudia, Zain A. Al-Safi, George Shade, Michael Kruger, Michael P. Diamond, Awoniyi O. Awonuga

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Purpose To compare the antecedent gynecological characteristics, indications for, and complications associated with, the different laparoscopic approaches to hysterectomy, in women with benign gynecological conditions. Methods A retrospective cohort study of 957 patients who underwent laparoscopic supracervical (LSH), total (TLH), and assisted vaginal (LAVH) hysterectomies between January 2003 and December 2009. Results Among 957 LH, 799 (83.5%) were LSH, 62 (6.4%) TLH, and 96 (10.1%) LAVH. Demographic characteristics were not different among the groups. Antecedent gynecologic conditions that were associated with the type of laparoscopic hysterectomy (LH) performed were: postmenopausal bleeding [LAVH vs. LSH, odds ratio (OR) 2.20; 95% confidence interval (CI) 1.04-4.65], previous pelvic surgery (TLH vs. LSH, OR 1.92; CI 1.05-3.52), previous cesarean delivery (LAVH vs. LSH, OR 0.39; CI 0.21-0.76), and prior hysteroscopy (LAVH vs. LSH, OR 0.29; CI 0.16-0.50). Preoperative diagnoses that were associated with the choice of LH were: menometrorrhagia (LAVH vs. LSH, OR 0.23; CI 0.14-0.38; TLH vs. LSH, OR 0.50; CI 0.26-0.98), uterine fibroids (LAVH vs. LSH, OR 0.25; CI 0.15-0.41), endometrial hyperplasia (TLH vs. LSH, OR 5.5; CI 2.04-14.84), and cervical dysplasia (TLH vs. LSH, OR 17.1; CI 6.83-42.79; LAVH vs. LSH, OR 8.05; CI 3.05-22.06). Estimated blood loss, operating time, and length of hospital stay were significantly reduced with LSH. Conclusion Antecedent gynecological history and the indications for surgery were associated with the type of LH performed in our institution. LSH was the most common approach and was associated with significantly less morbidity.

Original languageEnglish (US)
Pages (from-to)1353-1361
Number of pages9
JournalArchives of Gynecology and Obstetrics
Volume285
Issue number5
DOIs
StatePublished - May 1 2012
Externally publishedYes

Keywords

  • Laparoscopic hysterectomy
  • Laparoscopic supracervical hysterectomy
  • Laparoscopic-assisted vaginal hysterectomy
  • Total laparoscopic hysterectomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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  • Cite this

    Hobson, D. T. G., Imudia, A. N., Al-Safi, Z. A., Shade, G., Kruger, M., Diamond, M. P., & Awonuga, A. O. (2012). Comparative analysis of different laparoscopic hysterectomy procedures. Archives of Gynecology and Obstetrics, 285(5), 1353-1361. https://doi.org/10.1007/s00404-011-2140-2