Laparoscopic-Assisted Vaginal Hysterectomy vs Laparoscopic Supracervical Hysterectomy for Treatment of Nonprolapsed Uterus

Study ObjectiveTo compare perioperative outcomes between laparoscopic-assisted vaginal hysterectomy (LAVH) and laparoscopic supracervical hysterectomy (LSH) for the nonprolapsed uterus.DesignRetrospective chart analysis (Canadian Task Force classification II-2).SettingThree university-affiliated community hospitals.PatientsWomen undergoing LAVH or LSH because of benign indications without concomitant pelvic organ prolapse.InterventionLaparoscopic hysterectomy with or without adnexectomy.Measurements and Main ResultsData from 265 LAVH procedures and 181 LSH procedures performed at 3 university-affiliated community hospitals were included in the analysis from January 2001 to December 2007. The cases were successive. Exclusion criteria included surgery performed to treat malignancy or pelvic organ prolapse, and procedures that were converted to laparotomy. Two hundred forty-eight LAVH procedures and 173 LSH procedures were completed successfully. There was no significant difference in mean (SD) operating time between the 2 groups (145.1 [45.6] minutes for LAVH vs 143 [51.7] minutes for LSH; p = .66). Hospital stay was significantly shorter in the LSH group (1.6 [0.6] days vs 1.2 [0.5] days; p = .001). Patients in the LAVH group had significantly larger uterine weight (147.7 [84.8] g vs 121.5 [105.5] g; p = .005). Postoperative hemoglobin change and febrile morbidity were similar between the groups, as were overall perioperative complications (19% vs 15%, respectively; p = .36) and conversion rate to laparotomy (6.9% vs 4.6%; p = .27).ConclusionCompared with LAVH, LSH offers the benefits of a shorter hospital stay when performed in patients without uterine prolapse. Other perioperative outcomes studied were not significantly different between groups.