IJCRR - 8(2), January, 2016
A COMPARITIVE STUDY BETWEEN VAGINAL HYSTERECTOMY AND LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY
Author: Kavitha G., Renukadevi B., Rathna Ramamurthi, Rajarajeshwari S.
Introduction: Hysterectomy is the second most common surgical procedure performed by an Obstetrician and gynecologist next to Cesarean section. It can be performed by various methods, depending upon the pathology in the uterus, size of the uterus and the skill of the surgeon. Though there are a lot of advances in laparoscopic surgeries, most of the senior gynecologists feel that the laparoscopic hysterectomy have to replace abdominal hysterectomies but not vaginal hysterectomy and when ever feasible vaginal hysterectomy should be the method of choice for most cases of benign gynecological disease requiring hysterectomy. Objectives: The objective of the study is to compare the surgical and immediate post operative outcome for vaginal hysterectomy (VH) with those of laparoscopic assisted vaginal hysterectomy (LAVH). Methodology: This was a retrospective comparative study conducted among 200 patients who underwent vaginal hysterectomy/ (VH) laparoscopic assisted vaginal hysterectomy (LAVH) for various indication in the department of obstetrics and gynecology of Velammal medical college hospital and research centre from august 2012 to august 2015 (over period of 3yrs). The data were collected from medical records of the patient. The patients were divided into two groups of 100 each. Patients who underwent vaginal hysterectomy were grouped as VH and patients who underwent laparoscopic assisted vaginal hysterectomy were grouped as LAVH. The data was collected in terms of age, parity, history of previous surgeries, indications for surgery, operative time, and blood loss during surgery, intra-operative complication, post-operative complication and duration of hospital stay. The results were statistically analyzed with SPSS 16.0 version. Results: The baseline characteristics of both groups were similar. The mean operative time for the VH group was 90 minutes and 148 minutes for LAVH group (p=0.00). The mean blood loss for VH group was 152ml and 66ml for LAVH group (p=0.00). The incidence of vault hematoma was significantly more in the VH group and paralytic ileus was significantly higher in LAVH group. There was no significant difference between both groups in the incidence of hemorrhage, visceral injury and post operative pyrexia. Conclusion: Vaginal hysterectomy should be the preferred route of hysterectomy for benign conditions of the uterus whenever feasible, as it is associated with shorter operative time and early disappearance of post-operative pain.
Keywords: Vaginal hysterectomy, Laparoscopic assisted vaginal hysterectomy, Operative time, Post-operative pyrexia, Vault- hematoma, Paralytic ileus
Kavitha G., Renukadevi B., Rathna Ramamurthi, Rajarajeshwari S.. A COMPARITIVE STUDY BETWEEN VAGINAL HYSTERECTOMY AND LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY International Journal of Current Research and Review. 8(2), January, 84-90
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