scholarly journals TLH versus TAH: a 2 year retrospective comparative study

2019 ◽  
Vol 8 (10) ◽  
pp. 3939
Author(s):  
Anju Dogra ◽  
Vinay Kumar ◽  
Nishu Bhushan
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Wound Infection ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Laparoscopic hysterectomy has become a widely accepted technique worldwide, since its introduction by Reich in 1989. The aim of the study was to compare the surgical results and intra- operative and post-operative complications between total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH).Methods: Authors conducted a retrospective study at SMGS hospital, GMC Jammu between October 2016 to September 2018, 126 patients who underwent TLH and 126 patients who underwent TAH, were included.Results: Authors observed that there was no significant difference between the two groups in respect to patient’s age, parity and indication of surgery. Duration of surgery was found to be longer in TLH than TAH. The length of hospital stay was less in TLH than TAH. Hb drop was more in TAH group. 25 patients of TAH were given post op blood transfusion but only 9 patients of TLH were given post op blood transfusion. The time to ambulation in patients of TLH was much shorter than TAH. Wound infection was more common in TAH as compared to TLH, 5 patients had wound infection and in 4 patients resuturing was done for wound dehiscence. In 8 patients laparoscopy was converted to laparotomy because of adhesions, vascular injury and in one case because of bowel injury.Conclusions: This study showed that TLH can be safely performed by the experienced surgeon as an alternative to abdominal hysterectomy. It offers several benefits over TAH such as smaller incision, earlier ambulation, shorter hospital stay, faster recovery time and does not increase more serious complications than TAH.

scholarly journals Laparoscopic Hysterectomy Versus Abdominal Hysterectomy of Enlarged Uterus

2020 ◽  
Vol 3 (1) ◽  
pp. 01-08
Author(s):  
Bassem Islam
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Estimated Blood Loss ◽  
Significant Difference

This prospective interventional to assess feasibility of total laparoscopic hysterectomy (LH) for uteri weighing 280 gm or more. The study included 120 patients divided to 60 patient conducted total laparoscopic hysterectomies and 60 patients conduct total abdominal hysterectomy as standard method. Full history taking, gynecologic examination and ultrasound examination were done to all patients. The following data were collected from every patient in all groups: Age, BMI, uterine weight, Operative time, Estimated intraoperative blood loss, Preoperative hemoglobin and postoperative hemoglobin deficit 12 hours after surgery, intraoperative and Post-operative complications, Time to resumption of bowel movements to normal, Length of hospital stay. The most common indication among our patients was fibroid uterus while adenomyosis came second. All operations were performed by the same surgeons and using the same technique. We observe BMI is not considering as obstacle in laparoscopic group with advancement of anesthesia and sealing system. The mean operating time was slightly but not significally lower in laparoscopic hysterectomy with highly significant difference in the estimated blood loss in favor of laparoscopic group. The total incidence of intra-operative and postoperative complication of patient submitted to laparoscopic hysterectomy lower than conventional hysterectomy group but not statically significantly. There was significant difference in pain scoring, earlier bowel movement and hospital stay in the arm of laparoscopic group.

scholarly journals A comparative analysis of hysterectomies

Medicina ◽  
2007 ◽  
Vol 43 (2) ◽  
pp. 118 ◽  
Author(s):  
Rosita Aniulienė ◽  
Laima Varžgalienė ◽  
Manvydas Varžgalis
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Complication Rate ◽  
Vaginal Hysterectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Obstetrics And Gynecology ◽  
Significant Difference ◽  
The Mean

The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital. Methods. A retrospective review of medical histories was performed for women who had undergone three different types of hysterectomies (laparoscopic, vaginal, and abdominal) at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital during 2004–2005. Results. A total of 602 hysterectomies were performed: 51 (8.5%) laparoscopic, 203 (33.7%) vaginal, and 348 (57.8%) abdominal. The lowest complication rate occurred in patients who underwent laparoscopic hysterectomy (n=5, 9.8%) and the highest – abdominal hysterectomy (n=88, 25.2%) (P<0.05). More complication occurred after abdominal as compared to vaginal hysterectomy (n=88, 25.2% vs. n=20, 9.9%, respectively; P<0.05). There was no statistically significant difference in complication rate comparing laparoscopic and vaginal hysterectomies (P=0.26). The amount of blood loss depended on the type of hysterectomy – less blood was lost during laparoscopic and more during abdominal hysterectomy (123.4 vs. 308.5 mL, respectively; P<0.01). A significantly higher blood loss was observed during abdominal hysterectomy as compared to vaginal (195.3 mL) and vaginal as compared to laparoscopic hysterectomy (P<0.01). The mean length of hospital stay differed comparing all three types of hysterectomies: the shortest stay of 8.6 days was after laparoscopic, the longest of 13.7 days – after abdominal hysterectomy. The mean hospital stay was statistically significant shorter for vaginal hysterectomy compared to abdominal hysterectomy (9.1 vs. 13.7 days, P<0.01). The difference in mean length of hospital stay was insignificant comparing laparoscopic and vaginal hysterectomies (P>0.05). Conclusions. Abdominal hysterectomy was the most common procedure performed. The type of hysterectomy influenced the rate of complications – the lowest complication rate was after laparoscopic and vaginal hysterectomies. The amount of blood loss depended on the type of hysterectomy – the lowest was during laparoscopic hysterectomy. Abdominal hysterectomy required on average a longer hospital stay compared with laparoscopic and vaginal hysterectomies.

scholarly journals Laparoscopic Assisted Vaginal Hysterectomy: A Case Control Comparative Study with Total Abdominal Hysterectomy

2014 ◽  
Vol 8 (2) ◽  
pp. 59-62
Author(s):  
Fahmida Zesmin ◽  
Begum Hosne Ara ◽  
Fatema Begum ◽  
Nusrat Fatima
Keyword(s):  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Length Of Hospital Stay ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Case Control ◽  
Eligibility Criteria ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Number Of Patients ◽  
Significant Difference

This case control study was conducted in the department of Gynae & Obstetrics, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), Dhaka, during the period of January 2008 to December 2008 to compare the length of operation, blood loss, length of hospital stay, drug requirements for pain and post-operative pain and activity levels between Laparoscopically Assisted Vaginal Hysterectomy (LAVH) & Total Abdominal Hysterectomy (TAH). A total of 50 patients who met some eligibility criteria were consecutively included in the study and matched in a case control manner for age, weight, diagnosis & uterine size. The procedures were performed by the same surgeon. On average, LAVH operations took significantly longer than TAH operations (P<0.001). Equal number of patients of both groups (40%) needed blood transfusion. No significant difference about haemoglobin level compared to TAH group on 3rd POD (P=0.246). However total amount of analgesics needed was much higher in the TAH group than that of the LAVH group (243.7 ± 40.3VS 182.1 ± 69.6 mg; P= 0.005) and the total cost of operation was significantly less in the TAH group (4500 ± 500 takas) than in the LAVH group (6500 ± 500 taka) (P<0.001). It was observed that LAVH group produced earlier relief from pain in terms of pain VAS on 3rd POD, (P<0.001). LAVH is less painful, has a shorter length of hospital stay and quicker return to work than TAH. Moreover LAVH does not increase intra or postoperative complications. DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20370 Faridpur Med. Coll. J. 2013;8(2): 59-62

scholarly journals Comparative study of surgical results between total abdominal hysterectomy and total laparoscopic hysterectomy in a tertiary hospital: a 2 year retrospective study

2018 ◽  
Vol 7 (3) ◽  
pp. 1019
Author(s):  
Kanmani M. ◽  
Mirudhubashini Govindarajan ◽  
Vishranthi Selvaraj
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Pelvic Surgery ◽  
Surgical Results ◽  
Significant Difference

Background: Since the introduction of Laparoscopic hysterectomy by Reich in 1989, it has become a widely accepted technique worldwide. The aim of the study was to compare the surgical results between Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH).Methods: We conducted a retrospective study at Women’s center and hospitals between June 2014 to May 2016, 32 patients who underwent TAH and 55 patients who underwent TLH, were included.Results: We observed that there was no significant difference between the two groups in respect to patient's demographic characteristics, indication of surgery, uterine size, or with history of previous pelvic surgery. Duration of surgery was found to be longer in TLH than TAH (124±39.7 min vs. 104.7±39.8 min). The length of hospital stay was less in TLH than TLH (P-0.0001) and the amount of blood loss were also less in TLH than TAH (103±149 ml versus 243±210 ml). There was no significant difference in view of intra and post operative complications. Hemoglobin change was statistically significant and is more with TAH than TLH (1.57±0.7g% versus 1.12±0.7g%).Conclusions: This study showed that TLH can be safely performed by the experienced surgeon in order to reduce the blood loss, duration of hospital stay and the quality of life.

scholarly journals Indications and types of hysterectomy in the National Referral Hospital of Bhutan, 2020

2021 ◽  
Vol 7 (2) ◽  
pp. 19-23
Author(s):  
Namkha Dorji ◽  
Kencho Zangmo ◽  
Sangay Tshering ◽  
Renuka Mongar ◽  
Sonam Sonam
Keyword(s):  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Skin Incision ◽  
Referral Hospital ◽  
Gynecological Surgery ◽  
Duration Of Surgery ◽  
National Referral Hospital

Introduction: Hysterectomy, the removal of uterus, is a major gynecological surgery performed in Bhutan. It is performed for both benign and malignant gynecological conditions. This study was conducted to assess the socio-demographic profiles, types of hysterectomies and their indications, and duration of surgery and duration of peri-operative hospital stay among women who had hysterectomy at the national referral hospital of Bhutan.  Method: This was a retrospective study conducted at the Jigme Dorji Wangchuck National Referral Hospital, Thimphu. Data of women, who had hysterectomy from 1st January to 31st December, 2020 was extracted into a structured questionnaire by investigators from the patients record maintained at the record section, JDWNRH. Ethical approval was sought from the Research Ethics Board of Health. Data were entered into EpiData 3.1 and was analyzed using descriptive commands of STATA 13.1 Result: Hysterectomy comprised of 9.8% of gynecological surgery in 2020. The commonest route of approach was total abdominal hysterectomy which comprised of 81.7% of hysterectomies. It was found out that 92.9% of hysterectomies were performed under general anesthesia and 97.4% of the surgeries were done as elective or planned cases. The mean (+SD) duration of surgery from skin incision to closure was shortest for vaginal hysterectomy (68.8 + 17.6 minutes) and longest for total laparoscopic hysterectomy (210 + 35.2 minutes). The duration of peri-operative hospital stay was shortest for vaginal hysterectomy. Conclusion: Total abdominal hysterectomy was the common approach despite vaginal hysterectomy being performed under regional anesthesia with shorter duration of surgery and shorter hospital stays.

scholarly journals Comparison of Different Surgical Approaches for Hysterectomy: A Single-Institution Experience

2018 ◽  
pp. 1
Author(s):  
Yusuf Aytac Tohma ◽  
Mehmet Tunc ◽  
Emre Gunakan ◽  
Irem Kucukyildiz ◽  
Latife Atasoy Karakas ◽  
...  
Keyword(s):  
Vaginal Hysterectomy ◽  
Single Port ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Single Institution ◽  
Single Port Access ◽  
Port Access ◽  
Significant Difference ◽  
Duration Of Surgery

<p><strong>Objective:</strong> We aimed to compare surgical outcomes and postoperative complications among different hysterectomy approaches such as total abdominal hysterectomy, vaginal hysterectomy, multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy.</p><p><strong>Study Design:</strong> This retrospective, single institution, case control study was carried out at the Obstetrics and Gynecology Department of Baskent University in Ankara, Turkey. We evaluated 86 consecutive patients who underwent hysterectomy for benign gynecological conditions.</p><p><strong>Results:</strong> A total of 86 women underwent hysterectomy: 20 (23.3%) total abdominal hysterectomy, 20 (23.3%) vaginal hysterectomy, 27 (31.3%) multiport access laparoscopic hysterectomy, and 19 (22.1%) single-port access laparoscopic hysterectomy using a transumbilical single-port system. There was no significant difference in uterine size between groups (Z=5.705; p=0.127). A statistically significant (p&lt;0.001) difference in operation time (duration of surgery) was observed among the following groups. The duration of surgery for the multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy groups was similar, with these two laparoscopic procedures requiring significantly more time than total abdominal hysterectomy and vaginal hysterectomy procedures. There was no statistically significant difference in between hemoglobin levels before and after operation between groups. There was no statistically significant difference between groups in intraoperative and postoperative complications. Six patients experienced complications, one intraoperative and five postoperative. Intraoperative complication was ureter injury in single-port access laparoscopic hysterectomy group. The postoperative complication rate was 5.8% (5 cases) in 86 patients. Perirectal abscess in one patient and wound infection in two patients occurred in total abdominal hysterectomy group (15%). Urinary tract infection in one patient and vaginal cuff cellulitis in one patient occurred in vaginal hysterectomy group (4%). No complications were reported in multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy groups. Post-surgery, all patients who underwent single-port access laparoscopic hysterectomy reported that they were satisfied with their incision and cosmetic results.</p><p><strong>Conclusions:</strong> When technically feasible, multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy may be performed instead f total abdominal hysterectomy because of rapid recovery and shorter hospitalization however there are longer operating time.</p>

scholarly journals A comparative study between total laparoscopic hysterectomy and total abdominal hysterectomy for benign uterine pathologies at tertiary care institute, Udaipur

2021 ◽  
Vol 10 (10) ◽  
pp. 3806
Author(s):  
Shatendra Kumar Goyal ◽  
Madhubala Chauhan ◽  
Babita Kanwat ◽  
Dinesh Mehra
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Study Patient ◽  
Early Ambulation

Background: Hysterectomy is one of the most commonly performed procedures in gynaecological surgery. The most common indication is benign uterine disease. As the time is passing trend is towards those approaches which are minimally invasive, less painful, have less complications, less blood loss and are more cosmetic. Thus, total laparoscopic hysterectomy has gained popularity. The purpose of this study was to compare the 2 different routes of hysterectomy.Methods: In this prospective randomized observational study patients undergoing both the types of hysterectomy, that is, TAH (total abdominal hysterectomy) and TLH (total laparoscopic hysterectomy) during 2 year period at Rajkiya Pannadhay Mahila Chikitsalaya RNT medical college Udaipur were included in the study. 50 women (25 in each group) aged between 31-72 years were included into the study.Results: We observed that duration of surgery was found to be longer in TLH than TAH (112.56±19.45 min versus 57.9±19.26 min, P<0.001 (HS)). The length of hospital stay was less in TLH than TLH (p=0.0001) and the amount of intra-operative blood loss were also less in TLH than TAH (163.60±44.15 versus 313.20±123.48 ml, p<0.001). TLH group had early ambulation compared to TAH group (2.24±0.44 day versus 3.12 ±0.33 day, p<0.001), difference on the basis of length of hospital stay was highly significant which was shorter in TLH than TAH (4.40±1.15 versus 10.32±8.19 days, respectively; p<0.001). In current study patient satisfaction level was found highly significant between TLH and TAH (100% versus 56%, p<0.001).Conclusions: TLH is a safe and effective method of doing hysterectomy. The present study concluded that TLH is associated with less hospital stay, less blood loss, less use of analgesics, early ambulation, early start of oral feed, and better patient satisfaction. 

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

Open cystectomy is still alive and well: Outcomes from a single-centre 6-year review

2018 ◽  
Vol 12 (3) ◽  
pp. 239-245
Author(s):  
Alexios Dosis ◽  
Blessing Dhliwayo ◽  
Patrick Jones ◽  
Iva Kovacevic ◽  
Jonathan Yee ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Length Of Hospital Stay ◽  
Categorical Variables ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Single Centre ◽  
Significant Difference ◽  
Duration Of Surgery

Objectives: To compare perioperative and oncological outcomes between open and laparoscopic radical cystectomy in a single-centre setting. Materials and methods: This study was a retrospective cohort (level 2b evidence) non-randomised review of 228 radical cystectomies that were performed between January 2010 and February 2016. Primary outcome measures were operative time, complications, blood loss and length of hospital stay. Statistical analysis was performed using the SPSS v21.0. Quantitative values were compared with Student’s t-test; categorical variables with the chi-square test. Statistical significance was considered a result of an alpha value less than 0.05. A Kaplan–Meier survival analysis was also conducted. Results: Intraoperative blood loss was lower in laparoscopic surgery (855±673 vs. 716±570 mL, P=0.15), which had a significant impact on transfusion rates ( P=0.02). Operative times were lower in open surgery (339±52.9 vs. 353.1±67.1 minutes, P=0.10), while hospital stay was lower in the laparoscopic group (14.2±11.2 vs. 16.0±13.6 days, P=0.28). Five-year survival rates were superior for patients who underwent an open procedure but were not statistically significant ( P=0.10). Conclusion: This is, so far, the largest cohort to compare laparoscopic and open radical cystectomy. The laparoscopic approach can reduce the need for transfusion; however, there was no statistically significant difference in complication rates, duration of surgery, length of hospital stay or intraoperative blood loss, survival and margin positivity. Level of evidence: Not applicable for this multicentre audit.

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