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Erschienen in: Archives of Gynecology and Obstetrics 4/2011

01.10.2011 | General Gynecology

A prospective randomised study of total laparoscopic hysterectomy, laparoscopically assisted vaginal hysterectomy and non-descent vaginal hysterectomy for the treatment of benign diseases of the uterus

verfasst von: Kallol Kumar Roy, Manu Goyal, Shilpa Singla, Jai Bhagwan Sharma, Neena Malhotra, Sunesh Kumar

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2011

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Abstract

Aims and objectives

To compare the three techniques of hysterectomy—total laparoscopic hysterectomy (TLH), laparoscopic assisted vaginal hysterectomy (LAVH) and non-descent vaginal hysterectomy (NDVH).

Materials and methods

Ninety women with benign disease of uterus with failed medical management or not amenable to medical management were randomised into three groups for either technique of hysterectomy, thirty in each group, by the same surgeon. For each patient, intra-operative parameters including total duration of surgery, blood loss, surgical difficulty and intra-operative complications were recorded. Total hospital stay, adverse events, satisfaction rate and recuperation time was analysed and compared. Statistical analysis was done using SPSS15 software.

Results

Non-descent vaginal hysterectomy (NDVH) took least operative time and significantly lesser blood loss (p = 0.02) compared to TLH and LAVH. There was no significant difference between adverse events, recuperation time and postoperative pain between the three techniques.

Conclusions

Non-descent vaginal hysterectomy may be a preferred technique over laparoscopic hysterectomy for benign diseases of uterus where extensive pelvic dissection is not required.
Literatur
1.
Zurück zum Zitat Centers for Disease Control (CDC), MMWR (2002) Hysterectomy Surveillance—United States, 1994–1999. Surveillance summaries 51(SS05): 1–8 Centers for Disease Control (CDC), MMWR (2002) Hysterectomy Surveillance—United States, 1994–1999. Surveillance summaries 51(SS05): 1–8
2.
Zurück zum Zitat Singh AJ, Arora AK (2003) Effect of uterine prolapse on the lines of rural North Indian women. Singapore J Obstet Gynecol 34:52–58 Singh AJ, Arora AK (2003) Effect of uterine prolapse on the lines of rural North Indian women. Singapore J Obstet Gynecol 34:52–58
3.
Zurück zum Zitat Meikle SF, Nugent EW, Orleans M (1997) Complications and recovery from laparoscopy-assisted vaginal hysterectomy compared with abdominal and vaginal hysterectomy. Obstet Gynecol 89(2):304–311PubMedCrossRef Meikle SF, Nugent EW, Orleans M (1997) Complications and recovery from laparoscopy-assisted vaginal hysterectomy compared with abdominal and vaginal hysterectomy. Obstet Gynecol 89(2):304–311PubMedCrossRef
4.
Zurück zum Zitat Ribiero SC, Ribiero RM, Santos NC, Pinotti JA (2003) A randomised study of total abdominal, vaginal and laparoscopic hysterectomy. Int J Gynecol Obstet 83:37–43CrossRef Ribiero SC, Ribiero RM, Santos NC, Pinotti JA (2003) A randomised study of total abdominal, vaginal and laparoscopic hysterectomy. Int J Gynecol Obstet 83:37–43CrossRef
5.
Zurück zum Zitat Lumsden MA, Twaddle S, Hawthorn R (2000) A randomised comparison and economic evaluation of laparoscopic assisted hysterectomy and abdominal hysterectomy. BJOG 107:1386–1391PubMedCrossRef Lumsden MA, Twaddle S, Hawthorn R (2000) A randomised comparison and economic evaluation of laparoscopic assisted hysterectomy and abdominal hysterectomy. BJOG 107:1386–1391PubMedCrossRef
6.
Zurück zum Zitat Ajmera Sachin K, Mettler L, Jonat W (2006) Operative spectrum of hysterectomy in a German university hospital. J Obstet Gynecol India 56(1):59–63 Ajmera Sachin K, Mettler L, Jonat W (2006) Operative spectrum of hysterectomy in a German university hospital. J Obstet Gynecol India 56(1):59–63
7.
Zurück zum Zitat Chapron C, Laforest L, Ansquer Y, Fauconnier A, Fernandez B, Breart G et al (1999) Hysterectomy techniques used for benign pathologies: results of a French multicentric study. Hum Reprod 14(10):2464–2470PubMedCrossRef Chapron C, Laforest L, Ansquer Y, Fauconnier A, Fernandez B, Breart G et al (1999) Hysterectomy techniques used for benign pathologies: results of a French multicentric study. Hum Reprod 14(10):2464–2470PubMedCrossRef
8.
Zurück zum Zitat Matteson KA, Phipps MG, Raker C, Sacco LJ, Jackson AL (2009) Laparoscopic versus vaginal hysterectomy for benign pathology. Am J Obstet Gynecol 200:368e1–368e7CrossRef Matteson KA, Phipps MG, Raker C, Sacco LJ, Jackson AL (2009) Laparoscopic versus vaginal hysterectomy for benign pathology. Am J Obstet Gynecol 200:368e1–368e7CrossRef
9.
Zurück zum Zitat Summitt RL, Stovall TG, Lipscomb GH, Ling FW (1992) Randomised comparison of laparoscopic assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol 80:895–901PubMed Summitt RL, Stovall TG, Lipscomb GH, Ling FW (1992) Randomised comparison of laparoscopic assisted vaginal hysterectomy with standard vaginal hysterectomy in an outpatient setting. Obstet Gynecol 80:895–901PubMed
10.
Zurück zum Zitat Drahonovsky J, Haakova L, Otcenasek M, Krofta L, Kucera E, Feyereisl J (2010) A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy, and total laparoscopic hysterectomy in women with benign uterine disease. Eur J Obstet Gynecol Reprod Biol 148(2):172–176PubMedCrossRef Drahonovsky J, Haakova L, Otcenasek M, Krofta L, Kucera E, Feyereisl J (2010) A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy, and total laparoscopic hysterectomy in women with benign uterine disease. Eur J Obstet Gynecol Reprod Biol 148(2):172–176PubMedCrossRef
11.
Zurück zum Zitat Müller A, Thiel FC, Renner SP, Winkler M, Häberle L, Beckmann MW (2010) Hysterectomy-a comparison of approaches. Dtsch Arztebl Int 107(20):353–359PubMed Müller A, Thiel FC, Renner SP, Winkler M, Häberle L, Beckmann MW (2010) Hysterectomy-a comparison of approaches. Dtsch Arztebl Int 107(20):353–359PubMed
12.
Zurück zum Zitat Johnson N, Barlow D, Lethaby A, Tavender E, Curr E, Garry R (2006) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2:CD003677PubMed Johnson N, Barlow D, Lethaby A, Tavender E, Curr E, Garry R (2006) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2:CD003677PubMed
13.
Zurück zum Zitat Drahonovský J, Pán M, Baresová S, Kucera E, Feyereisl J (2006) Clinical comparison of laparoscopy-assisted vaginal hysterectomy (LAVH) and total laparoscopy hysterectomy (TLH) in women with benign disease of uterus–a prospective randomized study. Ceska Gynekol 71(6):431–437PubMed Drahonovský J, Pán M, Baresová S, Kucera E, Feyereisl J (2006) Clinical comparison of laparoscopy-assisted vaginal hysterectomy (LAVH) and total laparoscopy hysterectomy (TLH) in women with benign disease of uterus–a prospective randomized study. Ceska Gynekol 71(6):431–437PubMed
14.
Zurück zum Zitat Nieboer TE, Johnson N, Lethaby A, Tavender E, Curr E, Garry R, van Voorst S, Mol BW, Kluivers KB (2009) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 3:CD003677PubMed Nieboer TE, Johnson N, Lethaby A, Tavender E, Curr E, Garry R, van Voorst S, Mol BW, Kluivers KB (2009) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 3:CD003677PubMed
15.
Zurück zum Zitat Olsson J-H, Ferraz-Nunes J, Ellstrom M, Hahlin M (1998) A randomised trial with a cost-consequence analysis after laparoscopic and abdominal hysterectomy. Obstet Gynecol 91(1):30–34PubMedCrossRef Olsson J-H, Ferraz-Nunes J, Ellstrom M, Hahlin M (1998) A randomised trial with a cost-consequence analysis after laparoscopic and abdominal hysterectomy. Obstet Gynecol 91(1):30–34PubMedCrossRef
16.
Zurück zum Zitat Raju KS, Auld BJ (1994) A randomised study prospective study of laparoscopic vaginal hysterectomy versus abdominal hysterectomy each with bilateral salpingo-oophorectomy. Br J Obstet Gynecol 101:1068–1071CrossRef Raju KS, Auld BJ (1994) A randomised study prospective study of laparoscopic vaginal hysterectomy versus abdominal hysterectomy each with bilateral salpingo-oophorectomy. Br J Obstet Gynecol 101:1068–1071CrossRef
17.
Zurück zum Zitat Nezhat F, Nezhat C, Gordon S, Wilkins E (1992) Laparoscopic versus abdominal hysterectomy. J Reprod Med 37(3):247–250PubMed Nezhat F, Nezhat C, Gordon S, Wilkins E (1992) Laparoscopic versus abdominal hysterectomy. J Reprod Med 37(3):247–250PubMed
18.
Zurück zum Zitat Phipps JH, John M, Nayak S (1993) Comparison of laparoscopically assisted vaginal hysterectomy and bilateral salpingo-oophorectomy with conventional abdominal hysterectomy and bilateral salpingo-oophorectomy. Br J Obstet Gynecol 100:698–700CrossRef Phipps JH, John M, Nayak S (1993) Comparison of laparoscopically assisted vaginal hysterectomy and bilateral salpingo-oophorectomy with conventional abdominal hysterectomy and bilateral salpingo-oophorectomy. Br J Obstet Gynecol 100:698–700CrossRef
19.
Zurück zum Zitat Benassi L, Rossi T, Kaihura CT, Ricci L, Bedocchi L, Galanti B (2002) Abdominal or vaginal hysterectomy for enlarged uteri: a randomized clinical trial. Am J Obstet Gynecol 187:1561–1565PubMedCrossRef Benassi L, Rossi T, Kaihura CT, Ricci L, Bedocchi L, Galanti B (2002) Abdominal or vaginal hysterectomy for enlarged uteri: a randomized clinical trial. Am J Obstet Gynecol 187:1561–1565PubMedCrossRef
20.
Zurück zum Zitat Miskry T, Magos A (2003) Randomised, prospective, double-blind comparison of abdominal and vaginal hysterectomy in women without uterovaginal prolapse. Acta Obstet Gynecol Scand 82:351–358PubMedCrossRef Miskry T, Magos A (2003) Randomised, prospective, double-blind comparison of abdominal and vaginal hysterectomy in women without uterovaginal prolapse. Acta Obstet Gynecol Scand 82:351–358PubMedCrossRef
21.
Zurück zum Zitat Reich H, Decaprio J, McGlynn F (1989) Laparoscopic hysterectomy. J Gynecol Surg 5:213–216CrossRef Reich H, Decaprio J, McGlynn F (1989) Laparoscopic hysterectomy. J Gynecol Surg 5:213–216CrossRef
22.
Zurück zum Zitat Ottosen C, Lingman G, Ottosen L (2000) Three methods for hysterectomy: a randomised, prospective study of short term outcome. BJOG 107:1380–1385PubMedCrossRef Ottosen C, Lingman G, Ottosen L (2000) Three methods for hysterectomy: a randomised, prospective study of short term outcome. BJOG 107:1380–1385PubMedCrossRef
23.
Zurück zum Zitat Soriano D, Goldstein A, Lecuru F, Darai E (2001) Recovery from vaginal hysterectomy compared with laparoscopic assisted hysterectomy: a prospective, randomised, multicentric study. Acta Obstet Gynecol Scand 80:337–341PubMed Soriano D, Goldstein A, Lecuru F, Darai E (2001) Recovery from vaginal hysterectomy compared with laparoscopic assisted hysterectomy: a prospective, randomised, multicentric study. Acta Obstet Gynecol Scand 80:337–341PubMed
24.
Zurück zum Zitat Long CY, Fang JH, Chen WC, Su JH, Hsu SC (2002) Comparison of total laparoscopic hysterectomy and laparoscopically assisted vaginal hysterectomy. Gynecol Obstet Invest 53:214–219PubMedCrossRef Long CY, Fang JH, Chen WC, Su JH, Hsu SC (2002) Comparison of total laparoscopic hysterectomy and laparoscopically assisted vaginal hysterectomy. Gynecol Obstet Invest 53:214–219PubMedCrossRef
25.
Zurück zum Zitat Schindlbeck C, Klauser K, Dian D, Janni W, Friese K (2008) Comparison of total laparoscopic, vaginal and abdominal hysterectomy. Arch Gynecol Obstet 277(4):331–337PubMedCrossRef Schindlbeck C, Klauser K, Dian D, Janni W, Friese K (2008) Comparison of total laparoscopic, vaginal and abdominal hysterectomy. Arch Gynecol Obstet 277(4):331–337PubMedCrossRef
26.
Zurück zum Zitat David-Montefiore E, Rouzier R, Chapron C, Daraï E (2007) Surgical routes and complications of hysterectomy for benign disorders: a prospective observational study in French University Hospitals. Hum Reprod 22(1):260–265PubMedCrossRef David-Montefiore E, Rouzier R, Chapron C, Daraï E (2007) Surgical routes and complications of hysterectomy for benign disorders: a prospective observational study in French University Hospitals. Hum Reprod 22(1):260–265PubMedCrossRef
27.
Zurück zum Zitat Garry R, Fountain J, Mason S, Hawe J, Napp V, Abbott J, Clayton R, Phillips G, Whittaker M, Lilford R, Bridgman S, Brown J (2004) The eVALuate study: two parallel randomized trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ 328(7432):129–133PubMedCrossRef Garry R, Fountain J, Mason S, Hawe J, Napp V, Abbott J, Clayton R, Phillips G, Whittaker M, Lilford R, Bridgman S, Brown J (2004) The eVALuate study: two parallel randomized trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ 328(7432):129–133PubMedCrossRef
28.
Zurück zum Zitat Canis MJ, Wattiez A, Mage G, Bruhat MA (2004) Results of eVALuate study of hysterectomy techniques: laparoscopic hysterectomy may yet have a bright future. BMJ 328(7440):642–643PubMedCrossRef Canis MJ, Wattiez A, Mage G, Bruhat MA (2004) Results of eVALuate study of hysterectomy techniques: laparoscopic hysterectomy may yet have a bright future. BMJ 328(7440):642–643PubMedCrossRef
29.
Zurück zum Zitat Thiel F, renner S, Oppelt P (2006) Establishment of total laparoscopic hysterectomy (TLH in a university gynaecology department: results of the first 100 operations. Geburtshilfe Frauenheilkd 66:665–669CrossRef Thiel F, renner S, Oppelt P (2006) Establishment of total laparoscopic hysterectomy (TLH in a university gynaecology department: results of the first 100 operations. Geburtshilfe Frauenheilkd 66:665–669CrossRef
30.
Zurück zum Zitat Nascimento MC, Kelley A, Martitsch C, Weidner I, Obermair A (2005) Postoperative analgesic requirements - total laparoscopic hysterectomy versus vaginal hysterectomy. Aust N Z J Obstet Gynaecol 45(2):140–143PubMedCrossRef Nascimento MC, Kelley A, Martitsch C, Weidner I, Obermair A (2005) Postoperative analgesic requirements - total laparoscopic hysterectomy versus vaginal hysterectomy. Aust N Z J Obstet Gynaecol 45(2):140–143PubMedCrossRef
31.
Zurück zum Zitat Johnson N, Barlow D, Lethaby A, Tavender E, Curr L, Garry R (2005) Methods of hysterectomy: systematic review and meta-analysis of randomised controlled trials. BMJ 330(7506):1478PubMedCrossRef Johnson N, Barlow D, Lethaby A, Tavender E, Curr L, Garry R (2005) Methods of hysterectomy: systematic review and meta-analysis of randomised controlled trials. BMJ 330(7506):1478PubMedCrossRef
Metadaten
Titel
A prospective randomised study of total laparoscopic hysterectomy, laparoscopically assisted vaginal hysterectomy and non-descent vaginal hysterectomy for the treatment of benign diseases of the uterus
verfasst von
Kallol Kumar Roy
Manu Goyal
Shilpa Singla
Jai Bhagwan Sharma
Neena Malhotra
Sunesh Kumar
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 4/2011
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-010-1778-5

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