PROSPECTIVE RANDOMIZED COMPARISON BETWEEN AN OPEN AND CLOSED VAGINAL CUFF IN ABDOMINAL HYSTERECTOMY

Objective: To compare an operative and postoperative course of open va ginal cuff hysterectomy and closed vaginal cuff hysterectomy, and to c orrelate the length of stay, febrile morbidity and the incidence of pe lvic fluid collections to the type of surgery. Participants: One-hundr ed women scheduled for hysterectomy were prospectively randomized into two groups that underwent either a closed or an open vaginal cuff tec hnique. Results: The open vaginal cuff technique took on average 19% m ore time than the closed vaginal cuff operation (P < 0.05, t-test). Th e incidence and size of pelvic fluid collections was significantly hig her after the closed vaginal cuff hysterectomy than after the open tec hnique (P < 0.01, t-test). However, the postoperative length of stay, febrile morbidity and the rate of complications were similar. Conclusi ons: Both techniques of hysterectomy produced a similar postoperative course despite the fact that the closed vaginal cuff technique resulte d in a higher incidence of pelvic fluid collections. Therefore conside ring a shorter operation time for the closed vaginal cuff hysterectomy , this technique seems slightly preferable. (C) 1998 International Fed eration of Gynecology and Obstetrics.