Vaginal hysterectomy versus total laparoscopic hysterectomy for benign disease: a metaanalysis of randomized controlled trials.

Abstract:

OBJECTIVE:Recent randomized trials comparing total laparoscopic hysterectomy (TLH) and vaginal hysterectomy (VH) have produced conflicting results. The role of TLH in women suitable for VH remains uncertain. STUDY DESIGN:This study was a metaanalysis of randomized studies comparing TLH and VH for benign disease. Pooled outcome measures (odds ratio [OR] and weighted mean difference [WMD]) were calculated using random-effects models. RESULTS:No differences in perioperative complications, either total (pooled odds ratio, 0.87; P = .74) or by grade of severity, were demonstrated. TLH was associated with reduced postoperative pain scores (WMD -2.1; P = .03) and reduced hospital stay (WMD -0.62 days; P < .0001) but took longer to perform (WMD 29.3 minutes; P = .003). No differences in blood loss, rate of conversion to laparotomy, or urinary tract injury were identified. CONCLUSION:TLH may offer benefits compared with VH for benign disease, although this analysis is likely underpowered for rare complications. Further studies of long-term outcomes, including prolapse, urinary incontinence, and sexual function, are required.

journal_name

Am J Obstet Gynecol

authors

Gendy R,Walsh CA,Walsh SR,Karantanis E

doi

10.1016/j.ajog.2010.12.059

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

388.e1-8

issue

5

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(11)00017-2

journal_volume

204

pub_type

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