OBJECTIVE: Recent randomized trials comparing total laparoscopic hysterectomy (TLH) and vaginal hysterectomy (VH) have produced conflicting results. The role of TLH in women suitable for VH remains uncertain. STUDY DESIGN: This study was a metaanalysis of randomized studies comparing TLH and VH for benign disease. Pooled outcome measures (odds ratio [OR] and weighted mean difference [WMD]) were calculated using random-effects models. RESULTS: No differences in perioperative complications, either total (pooled odds ratio, 0.87; P = .74) or by grade of severity, were demonstrated. TLH was associated with reduced postoperative pain scores (WMD -2.1; P = .03) and reduced hospital stay (WMD -0.62 days; P < .0001) but took longer to perform (WMD 29.3 minutes; P = .003). No differences in blood loss, rate of conversion to laparotomy, or urinary tract injury were identified. CONCLUSION: TLH may offer benefits compared with VH for benign disease, although this analysis is likely underpowered for rare complications. Further studies of long-term outcomes, including prolapse, urinary incontinence, and sexual function, are required.
OBJECTIVE: Recent randomized trials comparing total laparoscopic hysterectomy (TLH) and vaginal hysterectomy (VH) have produced conflicting results. The role of TLH in women suitable for VH remains uncertain. STUDY DESIGN: This study was a metaanalysis of randomized studies comparing TLH and VH for benign disease. Pooled outcome measures (odds ratio [OR] and weighted mean difference [WMD]) were calculated using random-effects models. RESULTS: No differences in perioperative complications, either total (pooled odds ratio, 0.87; P = .74) or by grade of severity, were demonstrated. TLH was associated with reduced postoperative pain scores (WMD -2.1; P = .03) and reduced hospital stay (WMD -0.62 days; P < .0001) but took longer to perform (WMD 29.3 minutes; P = .003). No differences in blood loss, rate of conversion to laparotomy, or urinary tract injury were identified. CONCLUSION:TLH may offer benefits compared with VH for benign disease, although this analysis is likely underpowered for rare complications. Further studies of long-term outcomes, including prolapse, urinary incontinence, and sexual function, are required.
Authors: M P Radosa; G Meyberg-Solomayer; J Radosa; J Vorwergk; K Oettler; A Mothes; S Baum; I Juhasz-Boess; E Petri; E F Solomayer; I B Runnebaum Journal: Geburtshilfe Frauenheilkd Date: 2014-08 Impact factor: 2.915
Authors: K J Neis; W Zubke; T Römer; K Schwerdtfeger; T Schollmeyer; S Rimbach; B Holthaus; E Solomayer; B Bojahr; F Neis; C Reisenauer; B Gabriel; H Dieterich; I B Runnenbaum; W Kleine; A Strauss; M Menton; I Mylonas; M David; L-C Horn; D Schmidt; P Gaß; A T Teichmann; P Brandner; W Stummvoll; A Kuhn; M Müller; M Fehr; K Tamussino Journal: Geburtshilfe Frauenheilkd Date: 2016-04 Impact factor: 2.915
Authors: Dirk R Bulian; Linda Trump; Jürgen Knuth; Nicola Cerasani; Markus M Heiss Journal: Langenbecks Arch Surg Date: 2013-03-01 Impact factor: 3.445
Authors: Neal M Lonky; Yasmina Mohan; Vicki Y Chiu; Jeanna Park; Seth Kivnick; Christina Hong; Sharon M Hudson Journal: Womens Health (Lond) Date: 2017-06-29
Authors: Leo Francisco Limberger; Luciana Silveira Campos; Nilton Jacinto Rosa da Alves; Daniel Siqueira Pedrini; Andiara Souza de Limberger Journal: Ann Surg Innov Res Date: 2013-10-02