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  • Title: A retrospective and comparative study between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH).
    Author: Kulvanitchaiyanunt A.
    Journal: J Med Assoc Thai; 2004 Jul; 87(7):745-9. PubMed ID: 15521227.
    Abstract:
    OBJECTIVE: To compare the results of laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH). DESIGN: Retrospective and comparative study. SETTING: Department of Obstetrics and Gynecology, Ranong Hospital. SUBJECTS: 26 cases of LAVH and 63 cases of TAH who were operated on from February 1996 to September 2001. MATERIAL AND METHOD: Medical records of the patients were reviewed, by the same surgeon. The percentage and mean +/- SD data were analyzed a using chi-squared test and Fisher-Exact test to find the association. A p-value of < 0. 05 was regarded as significant. EVALUATION OF THE OUTCOMES: Operative time, estimated blood loss, parenteral analgesics, postoperative hospitalization, operative complications and operative cost. RESULTS: The baselines characteristics of both groups were similar The mean operative time for the LAVH group was 147.11 +/- 19.82 minutes, and 94.90 +/- 7.76 minutes for the TAH group. The mean length of postoperative hospitalization was 3.0 +/- 0.95 days for the LAVH group versus 5.7 +/- 0.81 days in the TAH group. There was no significant difference in the amount of estimated blood loss (369.23 +/- 57.00 ml in the LAVH and 33.41 +/- 51.97 ml in the TAH, p = 0. 143). The LAVH group used fewer parenteral analgesics (meperidine) than the TAH group ( 64.42 +/- 17.56 mg versus 132.14 +/- 23.94 mg). The operative costs were 11,653.85 +/- 1111.48 baht in the LAVH group and 6424.60 +/- 555.09 baht in the TAH group. There was one bladder injury in the LAVH group but there was no complication detected in the TAH group. CONCLUSION: There are some advantages as well as disadvantages in LAVH, compared to TAH. However, in Thailand the situation is not yet favorable; more learning experience is needed and more time to gain more confidence that LAVH is a more beneficial surgical technique.
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