A Prospective Randomized Study Comparing Total Laparoscopic Hysterectomy (TLH) Versus Minilaparotomy Hysterectomy (MLH) for benign Uterine Disorders in a Low-Resource Setting: Peri-Operative Outcome | ||||
Evidence Based Women's Health Journal | ||||
Article 47, Volume 11, Issue 4, November 2021, Page 326-333 PDF (415.73 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ebwhj.2021.70890.1132 | ||||
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Authors | ||||
Mahmoud Mohamed Awad 1; Adel Fathi Mohamed2; Hossam Elsayed Gouda3; Yousef Omar Aboelkhir3; Tarek Shokeir3; Mohamed Sayed Abdelhafez 4 | ||||
1Obstetrics & gynecology department, Faculty of medicine, Mansoura University, Mansoura, Egypt | ||||
2Oncology Center Mansoura University, Mansoura Faculty of Medicine, Mansoura, Egypt | ||||
3Department of Obstetrics and Gynecology, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt | ||||
4Obstetrics and Gynecology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||||
Abstract | ||||
Aim: To compare the perioperative outcomes between total laparoscopic hysterectomy (TLH) and minilaparotomy hysterectomy (MLH) in patients with benign uterine lesions. Study design: Randomized controlled trial. Patients and Methods: This study was conducted on 80 women suffering from benign uterine lesions and prepared for total abdominal hysterectomy in a tertiary university hospital in a low-resource setting. Patients were randomized one day before surgery into two groups; group 1 (TLH; n = 40) and group 2 (MLH; n = 40). The primary outcome measure was the estimated amount of blood loss. The secondary outcome measures were the operative time, changes in the hemoglobin (Hb) level and hematocrit (Hct) value, hospital stay peroid, intraoperative complications, and related early postoperative complications. Resuls: MLH has significantly lower amount of estimated blood loss (52.31 ± 20.19 vs 92.11 ± 26.40 ml; P < 0.001), and significantly lower operative time (65.26 ± 8.35 vs 93.68 ± 15.58 minutes; P < 0.001), and significantly lower percentage of postoperative drop in Hb level (5.32 ± 1.54% vs 7.18 ± 2.94%; P = 0.001) but with significantly higher hospital stay period (2.18 ± 0.39 vs 1.43 ± 0.56 days; P < 0.001). Both groups were comparable in the changes in the Hct value and complications rate. Conclusions: Compared with TLH, MLH offers favorable outcomes in terms of less operative time, less intraoperative bleeding, and short learning curve. Its safety, simplicity, and lower cost probably give the technique a higher privilege in communities with low-resource settings. | ||||
Keywords | ||||
Benign uterine disorders; blood loss; hysterectomy; laparoscopy; minilaparotomy | ||||
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