Prospective comparison of tissue trauma after laparoscopic hysterectomy types with retroperitoneal lateral transsection of uterine vessels using ligasure and abdominal hysterectomy (original) (raw)
Related papers
Acta Obstetricia et Gynecologica Scandinavica, 2000
Background. To evaluate clinical outcome and tissue trauma after laparoscopic and abdominal hysterectomy. Methods. Fifty women scheduled for abdominal hysterectomy were randomized to undergo either laparoscopic (nΩ25) or abdominal (nΩ25) hysterectomy. Surgical characteristics, hospital stay, convalescence and complications were analyzed. Blood samples for assay of markers of tissue trauma (interleukin-6, C-reactive protein, tumor-associated trypsin inhibitor and tumor-associated antigen CA 125) were taken preoperatively, on the first, second and seventh postoperative day and at the follow-up visit four weeks after surgery. Results. In uncomplicated hysterectomies (nΩ18) the operating time (85.3 min versus 57.5 min, pϽ0.00001) was longer for laparoscopic group but the hospital stay (2.1 days versus 3.4 days, pϽ0.00001) and sick leave (21.4 days versus 38.5 days, pϽ0.00001) were shorter in the laparoscopic group. Postoperative increases in all markers were significant in both groups. The interleukin-6 concentration was highest on the first postoperative day in both groups, that of C-reactive protein on the second postoperative day in both groups, tumor-associated trypsin inhibitor on the seventh postoperative day in the laparoscopic group and on the second postoperative day in the abdominal group and tumor-associated antigen CA 125 on the seventh postoperative day in both groups. Both interleukin-6 and C-reactive protein levels were lower in the laparoscopic group on the first (pΩ0.01 and pΩ0.03, respectively) and on the second postoperative day (pΩ0.02 and pϽ0.001, respectively) compared with the abdominal group. No differences were seen in tumor-associated trypsin inhibitor and tumor-associated antigen CA 125 levels between the groups. Conclusion. Laparoscopic hysterectomy should replace abdominal hysterectomy whenever possible because of a more favorable clinical outcome and less tissue trauma.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Laparoscopic surgery is associated with more favorable clinical outcome than conventional open surgery. This might be related to the magnitude of tissue trauma and tissue stress response. This study compares the intensity of tissue injury by assessing plasma C-reactive protein (CRP), lactic dehydrogenase (LDH), and cancer antigen 125 (CA 125) in patients undergoing laparoscopic hysterectomy compared to abdominal hysterectomy.Methods: This study was conducted at Ain Shams University Maternity Hospital from May 2018 to February 2020. 74 women candidate for hysterectomy were recruited and randomized into two groups: group A included 37 cases who underwent abdominal hysterectomy, and group B included 37 cases that underwent laparoscopic hysterectomy.Results: CRP, LDH and CA125 significantly increased post-operatively in both groups. Postoperative mean serum CRP, LDH and CA125 were significantly higher in the laparotomy group (10.84±2.47, 262.21±76.77, and 13.41±2.6 respectiv...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
Background: Vaginal hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim was to compare the risks and complications of laparoscopy assisted vaginal hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.Methods: A retrospective observational study was conducted in the Gynaecology ward at Vinakaya Mission’s Kirupananda Variyar Medical College and Hospitals, Salem, Tamil Nadu, India. The data for the past 1-year record was taken for analysis. A total of 80 subjects were included in the study and were divided into two groups with 40 patients under TAH (total abdominal hysterectomy) group and 40 under LAVH (Laproscopic assisted vaginal hysterectomy) group. The primary outcome of the present analysis was incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy,...
Gynecological Surgery, 2020
Objective To compare laparoscopic hysterectomy (LH) with total abdominal hysterectomy (TAH) regarding different outcome measures at our tertiary hospital. Study design This retrospective comparative cross-sectional study was conducted at the Department of Obstetrics and Gynecology Department, Women’s Hospital, Hamad Medical Corporation, Doha, Qatar. It included 44 patients who had LH (group 1) and 95 patients who had TAH (group 2) during the period from January 2009 through June 2014. Results Three patients were converted from LH to TAH and were excluded from the final analysis. The size of the uterus was smaller in the LH group than the TAH group (7.38 ± 1.92 vs 10.25 ± 3.84 cm, respectively; p < 0.0005). The operative time was shorter in TAH than in LH (2.22 ± 0.93 vs 2.43 ± 0.94, respectively; p = NS). The blood loss was less in the LH group than the TAH group (258.54 ± 65.26 vs 370.32 ± 74.8, respectively; p = NS). There were no significant differences between both groups reg...
Minimally Invasive Therapy & Allied Technologies, 2010
BACKGROUND Hysterectomy is the most frequently performed major gynecologic surgical procedure annually throughout the world.[1] The most common indication for hysterectomy is menorrhagia due to fibroids, followed by dysfunctional uterine bleeding.[2]. Regarding the procedure, three different approaches can be distinguished-abdominal, vaginal, and laparoscopic. Traditionally, abdominal hysterectomy (AH) has been used for Gynecological malignancy or if the uterus is enlarged. Vaginal hysterectomy (VH) was originally used only for prolapse, but it is now also used for dysfunctional uterine bleeding when the uterus is of fairly normal size.[3] Laparoscopic hysterectomy (LH) was introduced in 1988 and published in 1989 by Harry Reich as an alternative to abdominal hysterectomy. The first LH was set up as LH, as both uter ine ar ter ies were ligated laparoscopically, and most of the vagina opened laparoscopically. In 1992, already Reich described his foremost total laparoscopic hysterectomy (TLH).[3,4] However, in the 1990s, most gynecologists adopted the alternative laparoscopic-assisted vaginal hysterectomy (LAVH), an operation in which the upper blood supply to the uterus was ligated laparoscopically followed by a vaginal hysterectomy. Laparoscopic hysterectomy in general requires other technical skills than the vaginal or abdominal method.[4]Amongst all the standard approaches available, laparoscopic approach shows benefits of reduced intraoperative blood loss, smaller drop in hemoglobin level, shorter duration of hospital stay, speedier return to normal activities,tiny wound sizes, or abdominal wall infections.Few unspecified infections, however, at the cost of longer operating time and more urinary tract(bladder or ureter) injuries[5;6-10] have been documented in laparoscopic gynecological surgery.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: Laparoscopic technique of hysterectomy is becoming increasingly popular in developing and developed world. Laparoscopic hysterectomy is a minimal access procedure that allows patients to recover faster. The study was undertaken to assess the impact of two abdominal techniques (laparoscopic and conventional laparotomy) on various variables like operative time, hospital stay, complications and convalescence period.Methods: An observational longitudinal study was carried out at tertiary care centre. Two hundred and ten women, as per inclusion and exclusion criteria, who had undergone abdominal hysterectomy for benign uterine pathology, either by laparotomy (Group A) or by laparoscopic technique (Group B) during study period were included. Data was analyzed and compared by using different variables between two methods of hysterectomy, using percentages and Chi square test for normal distribution. P value less than 0.05 was considered significant.Results: The mean duration of...
Comparative Study between Different Methods of Laparoscopic Hysterectomies
Journal of Obstetrics Gynecology and Reproductive Sciences
Background: Hysterectomy is the second most common major surgical procedure performed on women after caesarean section. The incidence of hysterectomy is 4-6% out of which 90% are performed for benign indications. Aim of the work: The aim of this study was to compare intra- and post-operative morbidity associated with two types of laparoscopic hysterectomy. Laparoscopic-Assisted Vaginal Hysterectomy (LAVH) and Total Laparoscopic Hysterectomy (TLH) Patients and methods: A total of 80 women scheduled to undergo a hysterectomy for benign disease were subdivided into 2 groups; 40 women for LAVH and 40 women for TLH, Patients were excluded from the study if they had contraindication to laparoscopy. Intra- and post-operative evaluations including the duration of the operation uterine weight, frequency of intraoperative complication, and the difference between hemoglobin level prior to surgery and one day after surgery. Results: LAVH took the longest operating time. As regard hemoglobin def...
Analysis of Total Laparoscopic Hysterectomy Operations Performed in Our Clinic
Objective: The purpose of this study was to evaluate the results of our experience with 83 patients who underwent total laparoscopic hysterectomy (TLH). Methods: The subjects included 83 patients operated in Gaziosmanpaşa Taksim Training and Research Hospital, Department of Obstetrics and Gynecology. Total laparoscopic hysterectomies were performed for various indications between January 2013 and October 2014. Indications of total laparoscopic hysterectomy, method of operation, intraoperative and postoperative complications, duration of the operation, length of hospital stay, and blood loss in patients who underwent total laparoscopic hysterectomies were retrospectively evaluated. Results: In total, 83 patients were included in our study. The mean age was 49.3 years. The most common indication for total laparoscopic hysterectomy was menorrhagia. The mean body mass index (BMI) was 28.7±4.3. The mean operation time was 132.16±48.5 min, mean hospital stay was 3.38±1.6 days, and mean blood loss was 2 g/dL. The overall complication rate was 6%. Conclusion: Total laparoscopic hysterectomy is a preferred method to abdominal hysterectomy because it is associated with a more favorable surgical outcome. The laparoscopic approach is an acceptable treatment modality in the current gynecological practice. Total laparoscopic hysterectomy is more beneficial to patients because of low estimated blood loss, less analgesia use, low intraoperative and postoperative complication rates, less postoperative pain, more rapid recovery, and short hospital stays. However, the percentage of total laparoscopic hysterectomies is still very low. The longer operation time in total laparoscopic hysterectomy, an unfavorable learning curve, and extensive training of surgeons and the whole surgical team are often cited as reasons.
Analysis of Total Laparoscopic Hysterectomy Performed in Our Clinic
Journal of Academic Research in Medicine, 2015
Objective: The purpose of this study was to evaluate the results of our experience with 83 patients who underwent total laparoscopic hysterectomy (TLH). Methods: The subjects included 83 patients operated in Gaziosmanpaşa Taksim Training and Research Hospital, Department of Obstetrics and Gynecology. Total laparoscopic hysterectomies were performed for various indications between January 2013 and October 2014. Indications of total laparoscopic hysterectomy, method of operation, intraoperative and postoperative complications, duration of the operation, length of hospital stay, and blood loss in patients who underwent total laparoscopic hysterectomies were retrospectively evaluated. Results: In total, 83 patients were included in our study. The mean age was 49.3 years. The most common indication for total laparoscopic hysterectomy was menorrhagia. The mean body mass index (BMI) was 28.7±4.3. The mean operation time was 132.16±48.5 min, mean hospital stay was 3.38±1.6 days, and mean blood loss was 2 g/dL. The overall complication rate was 6%. Conclusion: Total laparoscopic hysterectomy is a preferred method to abdominal hysterectomy because it is associated with a more favorable surgical outcome. The laparoscopic approach is an acceptable treatment modality in the current gynecological practice. Total laparoscopic hysterectomy is more beneficial to patients because of low estimated blood loss, less analgesia use, low intraoperative and postoperative complication rates, less postoperative pain, more rapid recovery, and short hospital stays. However, the percentage of total laparoscopic hysterectomies is still very low. The longer operation time in total laparoscopic hysterectomy, an unfavorable learning curve, and extensive training of surgeons and the whole surgical team are often cited as reasons.