[COMPARISON OF LAPAROSCOPIC ASSISTED VAGINAL HYSTERECTOMY AND VAGINAL HYSTERECTOMY FOR BENIGN DISEASES AND LESIONS OF...

To compare the efficacy of laparoscopic assisted vaginal hysterectomy (LAVH) and vaginal hysterectomy (VH) carried out on the occasion of non-malignant diseases and lesions of the female genital system, by assessing the: operative time, price, blood loss, hospital stay, intra and postoperative complications, satisfaction of the patient.

The study included 187 women aged 38-71 years, with hysterectomy with or without salpingo-oophorectomy by LAVH-58 (31%) women or VH-129 (69%) women, on the occasion of non-malignant diseases and lesions of the female genital system. The patients are including in the study groups according to including and excluding criteria. Operation preparation, research and intra and postoperative follow-up of patients in both groups were the same. Standard, as performance is the surgical technique in both groups. The indicators are analyzed with the statistical program SPSS 10.1 for windows. Shi-square test, Fisher exact test were used in appropriate cases.

No significant difference between groups in terms of age (LAVH 48.7 ± 3.2 years; VH 52.7 ± 4.8 yrs), live births (1-3)/2 (1-2), total weight (62.6 kg/59 ± 7.2 kg) weight of the uterus (227 ±116.5/234 ±: 68.3). Most often Indications for LAVH are: CIN/CA in situ coli uteri--16.1%; myoma uteri--22.5%; ovarian tumor--15.5%, etc. Indications for VH: genital prolapse--53.5%; CIN/CA in situ--14.7%; recurrent endometrial polyp--14%, etc. Operative time: LAVH (126 ± 18.2), VH (68 ± 11.1), (p ≤ 0.05). Intraoperative blood loss: LAVH (16 ± 7 average drop in hemoglobin Hb), VH (10 ± 5 decline in Hb array) (p ≤ 0.05). We didn't find out significant differences between the patients of both groups in terms of hospital stay and satisfaction with the carried out operation. Intraoperative complications are more in the LAVH group and almos absence in VH group. Post-operative complications occur without statistical differences (we exclude urinary infections) in both groups studied.

In our study the VH showed better or equal results in the studied indicators in comparison with LAVH, therefore it is surgical intervention of choice compared to LAVH for removal of the uterus with or without the adnexa in non-malignant diseases and lesions of the female genital system. LAVH is the right choice in comparison with VH only in ovarian tumors and when we expected problems in women small pelvis.