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A Journal on Obstetrics and Gynecology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
Minerva Ginecologica 2007 April;59(2):99-105
Total laparoscopic hysterectomy versus vaginal hysterectomy: a prospective randomized trial
Morelli M., Caruso M., Noia R., Chiodo D., Cosco C., Lucia E., Biamonte M., Zullo F.
Dipartimento di Medicina Sperimentale e Clinica Facoltà di Medicina e Chirurgia, Cattedra di Ginecologia e Ostetricia, Università degli Studi di Catanzaro, “Magna Græcia”, Studi di Catanzaro, Catanzaro, Italia
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.