Laparoscopic hysterectomy versus abdominal hysterectomy: a controlled study of clinical and functional outcomes.

ABSTRACT

OBJECTIVE: To compare the clinical and functional outcomes of patients undergoing laparoscopic versus open hysterectomy for benign gynaecological pathology. SETTING: Gynaecological unit in a university hospital. METHODOLOGY: Forty consecutive cases of laparoscopic hysterectomy performed by the first author between June 1994 and December 1998 were reviewed. Their post-operative clinical and functional outcomes were compared with that of 40 patients with similar uterine size who had abdominal hysterectomy through a Pfannenstiel incision performed by consultant gynaecologists over the same time period. FINDINGS: Thirty-seven (92.5%) of the 40 patients had successful completion of laparoscopic hysterectomy. Of the patients who had successful laparoscopic hysterectomy, the duration of surgery was longer (mean duration 159 vs 98 minutes), but they had a lower risk of complications (8.1% vs 20%), reduced analgesic requirement (mean pethidine dose 93 vs 199 mg), and stayed for a shorter time in hospital (mean post-operation stay 3.1 vs 4.9 days) when compared with patients who had abdominal hysterectomy. They were also able to return to full domestic function and sexual activity earlier. More patients in the laparoscopic hysterectomy group were happy with the appearance with the surgical scar, and the overall satisfaction with the surgery was also more positive than those who had abdominal hysterectomy. CONCLUSION: Laparoscopic hysterectomy is associated with improved clinical and functional outcomes when compared with open hysterectomy.