Publication:

The uterine fibroid study: comparative study between total abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

ABSTRACT

Background To compare safety and efficacy of total abdominal hysterectomy (TAH) and laparoscopic assisted vaginal hysterectomy (LAVH) in uterine fibroid patients.

Methods It is a prospective observational study conducted at six major gynaecology hospitals located in Telangana State. The data was collected from November 2022 to April 2023 and all the safety and efficacy parameters were evaluated. The collected data entered in MS Excel and then analysed and statically evaluated by using GraphPad prism software. Internal consistency reliability Cronbach’s alpha was calculated.

Results There were 200 patients 100 each of TAH and LAVH. LAVH is less painful, has a shorter length of hospital stay and quicker return to work than TAH. On average, LAVH operations took significantly longer than TAH operations (47.9±5.953 minutes, 117.6±26.174 minutes, p<0.0001). The total length of hospital stay was significantly shorter after LAVH than after TAH (11.4±2.81 days, 2.66±0.95 days, p<0.0001). Although the haemoglobin drop in TAH was significantly higher than LAVH (173.15±40.872 and 92.5±6.83, p<0.0001), blood transfusions were more common in TAH (25 case versus 15 cases p=0.0306). The drug requirement to control pain during hospitalization after the two surgeries was not significantly different between the two groups. Fever was observed more often in the TAH group (P=0.01). Finally, Intra-operative and post-operative complications were lower in LAVH than TAH.

Conclusions LAVH is less painful, has a shorter length of hospital stay and quicker return to work than TAH. It has been concluded in present study that LAVH has become a major alternative to conventional abdominal hysterectomy with patient often opting laparoscopic approach for the result of cosmetic and faster recuperative reasons.