Objective : To compare the results of laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH).
Design : Retrospective and comparative study.
Setting : Department of Obstetrics and Gynecology, Ranong Hospital.
Subjects : 26 cases of LAVH and 63 cases of TAH who were operated on from February 1996 to September 2001.
Material and Method : Medical records of the patients were reviewed, by the same surgeon. The percentage and mean + SD data were analyzed a using chi-squared test and Fisher-Exact test to find the association. A p-value of < 0.05 was regarded as significant.
Evaluation of the outcomes : Operative time, estimated blood loss, parenteral analgesics, postoperative
hospitalization , operative complications and operative cost.
Results : The baselines characteristics of both groups were similar. The mean operative time for the LAVH group was 147.11 + 19.82 minutes, and 94.90 + 7.76 minutes for the TAH group. The mean length of postoperative hospitalization was 3.0 + 0.95 days for the LAVH group versus 5.7 + 0.81 days in the TAH group. There was no significant difference in the amount of estimated blood loss (369.23 + 57.00 ml in the LAVH and 33.41 + 51.97 ml in the TAH, p = 0.143). The LAVH group used fewer parenteral analgesics (meperidine) than the TAH group ( 64.42 + 17.56 mg versus 132.14 + 23.94 mg). The operative costs were 11,653.85 + 1111.48 baht in the LAVH group and 6424.60 + 555.09 baht in the TAH group. There was one bladder injury in the LAVH group but there was no complication detected in the TAH group.
Conclusion : There are some advantages as well as disadvantages in LAVH, compared to TAH. However, in Thailand the situation is not yet favorable; more learning experience is needed and more time to gain more
confidence that LAVH is a more beneficial surgical technique.
Keyword : Laparoscopically assisted vaginal hysterectomy (LAVH), Total abdominal hysterectomy (TAH)