A comparative study between laparoscopically assisted vaginal hysterectomy and abdominal hysterectomy.

OBJECTIVE To compare efficiency of laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH) MATERIAL AND METHOD: Medical records of 50 cases of LA VH and 50 cases of TAH were reviewed from January 2004 to December 2004 RESULTS There was no significant difference between the two groups in basic clinical characteristics. Myoma uteri was the major cause of operation. The operative time (115.9 +/- 40.8 min vs. 68.2 +/-14.2 min), the operative cost (26,763.48 +/- 2, 718.37 Baht vs. 22,345.50 +/- 4,057.40 Baht), diclofenac for postoperative analgesics (135.0 +/- 67.5 mg vs. 300.0 +/- 75.0 mg), the postoperative hospital stay (2.6 +/- 0.9 days vs. 4.5 +/- 1.1 days), and the time to return to work (30.4 + 3.1 days vs. 50.9 +/- 6.6 days) were significantly different in the LA VH group compared to the TAH group. There was no significant difference in blood loss between the two groups. The mean score of recovery scale for LAVH was 9 and 7 for TAH at the 28th day ofpost-op. There was one bladder injury in the LAVH group. The common complications in both groups were hemorrhage andfebrile morbidity. The learning curve of LA VHprocedure showed that operative time was significantly different between the 30th and 40th cases (122.0 +/- 31.8 min vs. 91.0 +/- 26.5 min). Doing LAVH with condition of uterine weight will not effect the operative time and blood loss. CONCLUSION LAVH is less painful, has a shorter length of hospital stay and quicker return to work than TAH. Moreover LAVH does not increase intra- or postoperative complications. LAVH is another alternative choice to treat myoma uteri in a well trained operator