M Morelli1, M Caruso, R Noia, D Chiodo, C Cosco, E Lucia, M Biamonte, F Zullo. 1. Dipartimento di Medicina Sperimentale e Clinica Facoltà di Medicina e Chirurgia, Cattedra di Ginecologia e Ostetricia, Università degli Studi di Catanzaro Magna Graecia, Studi di Catanzaro, Italy. morelli.mi@libero.it
Abstract
AIM: The aim of the study was to compare the effects of total laparoscopic hysterectomy with those of vaginal hysterectomy. METHODS: We conducted a prospective randomised trial on 400 patients who agreed to be randomized to eitherlaparoscopic total hysterectomy or vaginal hysterectomy. They were monitored for one year to evaluate the rate of major complications and the results on quality of life. RESULTS:Total laparoscopic hysterectomy was associated with a higher rate of major haemorrhages and ureteric injuries than vaginal hysterectomy (7% vs 2.5% and 2.5% vs 0%; P<0.05) only during the first year of study according to a normal learning-curve. It took longer to perform (85.9 min vs 46.6 min), but was less painful (visual analogue scale 5.3 vs 6.0; P<0.01) and there was a shorter stay in hospital after the operation (2.9 vs 3.3 days). Six weeks after the operation, total laparoscopic hysterectomy was associated with less pain and better quality of life than vaginal hysterectomy (SF-12). CONCLUSION:Total laparoscopic hysterectomy was associated with a significantly higher rate of major haemorrhages and ureteric injuries than vaginal hysterectomy only during the first year of study according to a normal learning-curve. It took longer to perform but was associated with less pain, quicker recovery, and better short term quality of life.
RCT Entities:
AIM: The aim of the study was to compare the effects of total laparoscopic hysterectomy with those of vaginal hysterectomy. METHODS: We conducted a prospective randomised trial on 400 patients who agreed to be randomized to either laparoscopic total hysterectomy or vaginal hysterectomy. They were monitored for one year to evaluate the rate of major complications and the results on quality of life. RESULTS: Total laparoscopic hysterectomy was associated with a higher rate of major haemorrhages and ureteric injuries than vaginal hysterectomy (7% vs 2.5% and 2.5% vs 0%; P<0.05) only during the first year of study according to a normal learning-curve. It took longer to perform (85.9 min vs 46.6 min), but was less painful (visual analogue scale 5.3 vs 6.0; P<0.01) and there was a shorter stay in hospital after the operation (2.9 vs 3.3 days). Six weeks after the operation, total laparoscopic hysterectomy was associated with less pain and better quality of life than vaginal hysterectomy (SF-12). CONCLUSION: Total laparoscopic hysterectomy was associated with a significantly higher rate of major haemorrhages and ureteric injuries than vaginal hysterectomy only during the first year of study according to a normal learning-curve. It took longer to perform but was associated with less pain, quicker recovery, and better short term quality of life.
Authors: Garri Tchartchian; Bernd Bojahr; Sven Becker; Attilio Di Spiezio Sardo; Vasilis Tanos; Hugo C Verhoeven; Markus Wallwiener; Rudy L De Wilde Journal: J Obstet Gynaecol India Date: 2018-12-04
Authors: Johanna W M Aarts; Theodoor E Nieboer; Neil Johnson; Emma Tavender; Ray Garry; Ben Willem J Mol; Kirsten B Kluivers Journal: Cochrane Database Syst Rev Date: 2015-08-12
Authors: Santiago Horgan; John P Cullen; Mark A Talamini; Yoav Mintz; Alberto Ferreres; Garth R Jacobsen; Bryan Sandler; Julie Bosia; Thomas Savides; David W Easter; Michelle K Savu; Sonia L Ramamoorthy; Emily Whitcomb; Sanjay Agarwal; Emily Lukacz; Guillermo Dominguez; Pedro Ferraina Journal: Surg Endosc Date: 2009-04-03 Impact factor: 4.584