Comparison of two procedures for laparovaginal hysterectomy: a randomized trial

Objective: To compare peroperative parameters of two variants of a laparova ginal hysterectomy in surgical management of gynecological conditions. Meth ods: A prospective randomized study of 70 laparovaginal hysterectomies perf ormed by the same two surgeons for disease of female pelvic organs. The fol lowing criteria were studied: indication for surgery, previous surgery, dur ation of the procedure, recovery, hospital stay, blood loss, tissue damage markers, hysterectomy proportions and complication incidence. Statistical a nalysis was performed using the non-parametric chi(2)-test and non-parametr ic Fischer's exact probability test when appropriate, with a level of signi ficance P=0.05. Results: Totals of 38 (54.3%) laparoscopy-assisted vaginal and 31 (45.7%) vaginally assisted laparoscopic hysterectomies were performe d for fibroma as the main indication. Conversion to laparotomy was applied in only one patient. The VALH group (P=0.01) showed both fewer procedures a nd shorter hospital stay with insignificant blood loss. Conclusion: The two variants of a laparovaginal hysterectomy appear to be safe and appropriate , effective procedures for women with gynecological conditions. Furthermore , vaginally assisted laparoscopic hysterectomy has been shown to be superio r to laparoscopy-assisted vaginal hysterectomy in terms of shorter operatin g time and greater palliative effect upon the complex of uterosacral ligame nts. Laparoscopic surgery can alter the relationship between vaginal and ab dominal hysterectomy. (C) 2000 Elsevier Science Ireland Ltd. All rights res erved.