Vaginal or laparoscopic hysterectomy: Do perioperative outcomes differ? A propensity score-matched analysis

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Vaginal hysterectomy (VH) is often considered preferred for minimally invasive hysterectomy.
• Laparoscopic hysterectomy (LH) rates are increasing, while VH rates remain stable.

Purpose of the Study:

• To compare perioperative outcomes between laparoscopic hysterectomy (LH) and vaginal hysterectomy (VH).

Main Methods:

• Retrospective review of women undergoing LH or VH for benign indications (2009-2015).
• Propensity score-matched analysis to control for patient differences.
• Outcomes assessed: complications, operative time, blood loss, hospital stay, conversion, and readmission.

Main Results:

• LH demonstrated significantly lower blood loss (102.8 mL vs. 185.0 mL) and shorter hospital stays (0.9 days vs. 1.2 days).
• Concomitant adnexal surgery was more frequent with LH (47.7%), while prolapse surgery was more common with VH (68.4%).
• No significant differences in most intraoperative and postoperative characteristics were observed between the matched groups.

Conclusions:

• Both VH and LH offer favorable perioperative outcomes.
• LH is associated with reduced blood loss and shorter hospital stays.
• The findings support the increasing adoption of laparoscopic hysterectomy for appropriate cases.