Abstract
Objective: We aimed to clarify the trends in outcomes of various types of hysterectomy in our hospital. We also assessed the factors that influenced operating time and intraoperative blood loss in patients who underwent hysterectomy.
Design: We conducted a retrospective study and evaluated a total of 293 patients who underwent abdominal or laparoscopic hysterectomy between 2008 and 2013.
Main Outcome and Measure(s): We measured operating time, intraoperative blood loss, uterine weight, and surgical complications.
Result(s): The proportion of total laparoscopic hysterectomy (TLH) performed has been increasing in recent years. In 2013, TLH accounted for 72.9% of all cases of hysterectomy in our facility. Fourteen of 152 patients (9.2%) in our study who underwent laparoscopic surgery required conversion to laparotomy. Median operating time in TLH was significantly longer than in laparoscopically assisted vaginal hysterectomy (LAVH) and abdominal total hysterectomy (ATH). Median intraoperative blood loss was significantly lower in TLH than in LAVH and ATH. Median weight of the uterus removed by ATH was greater than that removed by LAVH and TLH. In laparoscopic hysterectomy, there was a positive correlation between uterine weight and operating time. Intraoperative complications occurred in two LAVH patients and in four TLH patients. Postoperative complications in the TLH group included two cases of uretero-vaginal fistula and one case of hematoma of the vaginal cuff. Postoperative complications occurred in four cases in the ATH group.
Conclusion(s): Our clinical proficiency with TLH is increasing, and we believe that continued experience and technical improvements in laparoscopic hysterectomy will lead to improved safety and effectiveness of the procedure.
