Comparative analysis of different laparoscopic hysterectomy procedures

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

Research output: Contribution to journalArticle

16 Citations (Scopus)

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

Fingerprint

Hysterectomy
Odds Ratio
Confidence Intervals
Length of Stay
Uterine Cervical Dysplasia
Endometrial Hyperplasia
Vaginal Hysterectomy
Hysteroscopy
Leiomyoma
Cohort Studies
Retrospective Studies
History
Demography
Hemorrhage
Morbidity

Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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

Comparative analysis of different laparoscopic hysterectomy procedures. / Hobson, Deslyn T.G.; Imudia, Anthony N.; Al-Safi, Zain A.; Shade, George; Kruger, Michael; Diamond, Michael Peter; Awonuga, Awoniyi O.

In: Archives of Gynecology and Obstetrics, Vol. 285, No. 5, 01.05.2012, p. 1353-1361.

Research output: Contribution to journalArticle

Hobson, DTG, Imudia, AN, Al-Safi, ZA, Shade, G, Kruger, M, Diamond, MP & Awonuga, AO 2012, 'Comparative analysis of different laparoscopic hysterectomy procedures', Archives of Gynecology and Obstetrics, vol. 285, no. 5, pp. 1353-1361. https://doi.org/10.1007/s00404-011-2140-2
Hobson, Deslyn T.G. ; Imudia, Anthony N. ; Al-Safi, Zain A. ; Shade, George ; Kruger, Michael ; Diamond, Michael Peter ; Awonuga, Awoniyi O. / Comparative analysis of different laparoscopic hysterectomy procedures. In: Archives of Gynecology and Obstetrics. 2012 ; Vol. 285, No. 5. pp. 1353-1361.
@article{715432f4b2244325acb3644522ce2e3b,
title = "Comparative analysis of different laparoscopic hysterectomy procedures",
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.",
keywords = "Laparoscopic hysterectomy, Laparoscopic supracervical hysterectomy, Laparoscopic-assisted vaginal hysterectomy, Total laparoscopic hysterectomy",
author = "Hobson, {Deslyn T.G.} and Imudia, {Anthony N.} and Al-Safi, {Zain A.} and George Shade and Michael Kruger and Diamond, {Michael Peter} and Awonuga, {Awoniyi O.}",
year = "2012",
month = "5",
day = "1",
doi = "10.1007/s00404-011-2140-2",
language = "English (US)",
volume = "285",
pages = "1353--1361",
journal = "Archives of Gynecology and Obstetrics",
issn = "0932-0067",
publisher = "Springer Verlag",
number = "5",

}

TY - JOUR

T1 - Comparative analysis of different laparoscopic hysterectomy procedures

AU - Hobson, Deslyn T.G.

AU - Imudia, Anthony N.

AU - Al-Safi, Zain A.

AU - Shade, George

AU - Kruger, Michael

AU - Diamond, Michael Peter

AU - Awonuga, Awoniyi O.

PY - 2012/5/1

Y1 - 2012/5/1

N2 - 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.

AB - 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.

KW - Laparoscopic hysterectomy

KW - Laparoscopic supracervical hysterectomy

KW - Laparoscopic-assisted vaginal hysterectomy

KW - Total laparoscopic hysterectomy

UR - http://www.scopus.com/inward/record.url?scp=84862765947&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862765947&partnerID=8YFLogxK

U2 - 10.1007/s00404-011-2140-2

DO - 10.1007/s00404-011-2140-2

M3 - Article

C2 - 22124531

AN - SCOPUS:84862765947

VL - 285

SP - 1353

EP - 1361

JO - Archives of Gynecology and Obstetrics

JF - Archives of Gynecology and Obstetrics

SN - 0932-0067

IS - 5

ER -