Study to analyse the intraoperative and post-operative complications of total abdominal hysterectomy and total laparoscopic hysterectomy

Abstract

Background: Laparoscopic hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim of the study was to compare the risks and complications of total laparoscopy hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications. Methods: A retrospective observational study was conducted in the Gynaecology department at Department of Obstetrics and Gynecology, Central Railway Hospital, Jabalpur, Madhya Pradesh, India. The data for the past 2-year record was taken for analysis. A total of 72 subjects were included in the study and were divided into two groups with 36 patients under TAH (total abdominal hysterectomy) group and 36 under TLH (Total Laproscopic hysterectomy) group. The primary outcome of the present analysis were incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of post operative stay. Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (215 ml) compared to TLH group (124 ml) and the difference was found to be statistically significant (p<0.05). Similarly, the duration of operative procedure was found to be less in TLH group (46.5 mins) compared to TAH group (76.8 mins) and the difference was found to be statistically significant (p<0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the TLH group and the difference was found to be statistically significant (p<0.05). Conclusions: TLH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.