A Prospective Randomized Study Comparing Total Laparoscopic Hysterectomy (TLH) Versus Minilaparotomy Hysterectomy (MLH) for benign Uterine Disorders in a Low-Resource Setting: Peri-Operative Outcome

Awad, Mahmoud Mohamed; Mohamed, Adel Fathi; Gouda, Hossam Elsayed; Aboelkhir, Yousef Omar; Shokeir, Tarek; Abdelhafez, Mohamed Sayed

doi:10.21608/ebwhj.2021.70890.1132

A Prospective Randomized Study Comparing Total Laparoscopic Hysterectomy (TLH) Versus Minilaparotomy Hysterectomy (MLH) for benign Uterine Disorders in a Low-Resource Setting: Peri-Operative Outcome

Document Type : Original Article

Authors

¹ Obstetrics &amp; gynecology department, Faculty of medicine, Mansoura University, Mansoura, Egypt

² Oncology Center Mansoura University, Mansoura Faculty of Medicine, Mansoura, Egypt

³ Department of Obstetrics and Gynecology, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt

⁴ Obstetrics and Gynecology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

10.21608/ebwhj.2021.70890.1132

Abstract

Aim: To compare the perioperative outcomes between total laparoscopic hysterectomy (TLH) and minilaparotomy hysterectomy (MLH) in patients with benign uterine lesions.
Study design: Randomized controlled trial.
Patients and Methods: This study was conducted on 80 women suffering from benign uterine lesions and prepared for total abdominal hysterectomy in a tertiary university hospital in a low-resource setting. Patients were randomized one day before surgery into two groups; group 1 (TLH; n = 40) and group 2 (MLH; n = 40). The primary outcome measure was the estimated amount of blood loss. The secondary outcome measures were the operative time, changes in the hemoglobin (Hb) level and hematocrit (Hct) value, hospital stay peroid, intraoperative complications, and related early postoperative complications.
Resuls: MLH has significantly lower amount of estimated blood loss (52.31 ± 20.19 vs 92.11 ± 26.40 ml; P < 0.001), and significantly lower operative time (65.26 ± 8.35 vs 93.68 ± 15.58 minutes; P < 0.001), and significantly lower percentage of postoperative drop in Hb level (5.32 ± 1.54% vs 7.18 ± 2.94%; P = 0.001) but with significantly higher hospital stay period (2.18 ± 0.39 vs 1.43 ± 0.56 days; P < 0.001). Both groups were comparable in the changes in the Hct value and complications rate.
Conclusions: Compared with TLH, MLH offers favorable outcomes in terms of less operative time, less intraoperative bleeding, and short learning curve. Its safety, simplicity, and lower cost probably give the technique a higher privilege in communities with low-resource settings.

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