OBJECTIVE: To compare intraoperative hemorrhage and other operative parameters after laparoscopically assisted vaginal hysterectomy (LAVH) versus total abdominal hysterectomy (TAH) for benign gynecologic conditions. DESIGN: A prospective, randomized, controlled trial. MATERIALS AND METHODS:Between April 2010 and March 2011, 50 Thai patients with strong indications for hysterectomy--with uterine sizes ≤16 weeks of gravid uterus and with no contraindications for open or laparoscopic surgeries--were randomly assigned for LAVH or TAH. MAIN OUTCOME MEASURES: Intraoperative blood loss, operating time, postoperative analgesic requirements, perioperative complications, and duration of hospitalization. RESULTS:Intraoperative blood loss was significantly less in the LAVH group (median 120 mL [range 50-300]) than in the TAH group (median 250 mL [105-800]) (median difference 130 mL, p <.001, 95% confidence interval [CI] 55-200). The LAVH group required significantly less postoperative morphine sulfate administration (median 3 mg [range 0-12]) than the TAH group (15 mg [6-24]) (median difference 9 mg, p <.001, 95% CI 9-12). The hospital stay for the LAVH group (median 3 days; range 2-7) was significantly shorter than that of the TAH group (median 4 days; range 4-5) (median difference 2 days, p <.001, 95% CI 1-2). The operating time was comparable between the 2 groups (median 100 minutes; range 50-240) for the LAVH and 115 minutes (range 60-200) for the TAH group (median difference 5 minutes, p =.592, 95% CI -15-25). There were no conversions from a LAVH to a laparotomy. CONCLUSIONS: The LAVH has advantages over the TAH in that in the former there is less intraoperative blood loss, less postoperative morphine requirement, and a shorter duration of postoperative hospital stays.
RCT Entities:
OBJECTIVE: To compare intraoperative hemorrhage and other operative parameters after laparoscopically assisted vaginal hysterectomy (LAVH) versus total abdominal hysterectomy (TAH) for benign gynecologic conditions. DESIGN: A prospective, randomized, controlled trial. MATERIALS AND METHODS: Between April 2010 and March 2011, 50 Thai patients with strong indications for hysterectomy--with uterine sizes ≤16 weeks of gravid uterus and with no contraindications for open or laparoscopic surgeries--were randomly assigned for LAVH or TAH. MAIN OUTCOME MEASURES: Intraoperative blood loss, operating time, postoperative analgesic requirements, perioperative complications, and duration of hospitalization. RESULTS:Intraoperative blood loss was significantly less in the LAVH group (median 120 mL [range 50-300]) than in the TAH group (median 250 mL [105-800]) (median difference 130 mL, p <.001, 95% confidence interval [CI] 55-200). The LAVH group required significantly less postoperative morphine sulfate administration (median 3 mg [range 0-12]) than the TAH group (15 mg [6-24]) (median difference 9 mg, p <.001, 95% CI 9-12). The hospital stay for the LAVH group (median 3 days; range 2-7) was significantly shorter than that of the TAH group (median 4 days; range 4-5) (median difference 2 days, p <.001, 95% CI 1-2). The operating time was comparable between the 2 groups (median 100 minutes; range 50-240) for the LAVH and 115 minutes (range 60-200) for the TAH group (median difference 5 minutes, p =.592, 95% CI -15-25). There were no conversions from a LAVH to a laparotomy. CONCLUSIONS: The LAVH has advantages over the TAH in that in the former there is less intraoperative blood loss, less postoperative morphine requirement, and a shorter duration of postoperative hospital stays.
Authors: Emily P Barnard; Ahmed M AbdElmagied; Lisa E Vaughan; Amy L Weaver; Shannon K Laughlin-Tommaso; Gina K Hesley; David A Woodrum; Vanessa L Jacoby; Maureen P Kohi; Thomas M Price; Angel Nieves; Michael J Miller; Bijan J Borah; Krzysztof R Gorny; Phyllis C Leppert; Lisa G Peterson; Elizabeth A Stewart Journal: Am J Obstet Gynecol Date: 2017-01-05 Impact factor: 8.661
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Authors: Julia Caroline Radosa; Marc Philipp Radosa; Julia Sarah Maria Zimmermann; Eva-Marie Braun; Sebastian Findeklee; Annette Wieczorek; Lisa Stotz; Amr Hamza; Ferenc Zoltan Takacs; Uda Mareke Risius; Christoph Gerlinger; Christoph Georg Radosa; Stefan Wagenpfeil; Erich-Franz Solomayer Journal: Arch Gynecol Obstet Date: 2021-05-03 Impact factor: 2.493
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