Total Laparoscopic Hysterectomy versus Total Abdominal Hysterectomy in Women with Endometrial Neoplasia; Randomized Controlled Clinical Trial

Document Type : Original Article

Authors

1 Obstetrics and gynecology faculty of medicine Ain shams University Cairo Egypt

2 Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

3 Obstetrics and gynecology ، faculty of medicine, Ain Shams University, Cairo , Egypt

Abstract

Background: Laparoscopic hysterectomy is minimally invasive surgery in the management of endometrial neoplasia and its safety and efficacy has nearly the same rate of complications in comparison with abdominal hystrectomy with less intraoperative blood loss and less postoperative pain.
Aim of the Work: To compare operative time between total laparoscopy hysterectomy with bilateral salpingoophrectomy (TLH+BSO) versus total abdominal hysterectomy and bilateral salpingooophorectomy (TAH+BSO) in women with endometrial neoplaia.
Patients and Methods: The current study was conducted in Ain-Sham University Maternity Hospital during the period between January 2017 to May 2018. It included a total number of 52 women recruited from outpatient gynecology clinic. All were complaining of premenopausal or postmenopausal bleeding and diagnosed as having endometrial hyperplasia or endometrial carcinoma.
Results: On comparing both groups, there was no significant difference between total operative time between both groups but, TLH with BSO had more prolonged operative time than TAH with BSO, there was significant decrease in intraoperative blood loss, post-operative pain and less post-operative pelvic pain in TLH group. There were no significant difference regarding intra or post-operative complications, need for blood transfusion, hospital stay and post-operative return to daily activities or sexual satisfaction.
Conclusion: Laparoscopic hysterectomy proved safety and efficacy in the management of endometrial neoplasia either endometrial hyperplasia or malignancy with no significant difference regarding operative time with less intraoperative blood loss and postoperative pain with same rate of complications as abdominal route.

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