Evaluation of Uterine Volume in Total Laparoscopic Hysterectomy for Uterine Leiomyomas

Abstract

Background: The aim of this retrospective study was to evaluate uterine volume in patients who underwent transabdominal hysterectomy (TAH) or total laparoscopic hysterectomy (TLH) for uterine leiomyomas in our teaching hospital and to determine the appropriate uterine volume in patients who could undergo TLH.

Methods: This retrospective study was based on a cohort 47 consecutive cases that underwent TLH for uterine leiomyomas in our institution between April 2008 and April 2012 (TLH group). Controls were defined as 134 patients who underwent TAH for uterine leiomyomas in our institution between April 2008 and April 2012 (TAH group).

Results: The TLH group comprised 45 cases because two surgeries in the TLH group were converted to TAH. Uterine volume was significantly smaller in the TLH group than in the TAH group (median 342 g vs. 788 g). Surgical duration was significantly longer in the TLH group than in the TAH group (median 214 minutes vs. 152 minutes). Blood loss was significantly lower in the TLH group than in the TAH group (median 0 mL vs. 250 mL). The incidence of postoperative complications was lower in the TLH group than in the TAH group (0/45 vs. 15/134). The hospital stay was significantly shorter for the TLH group than for the TAH group. In the TLH group, surgical duration correlated with uterine volume (regression coefficient = 1.6598, P = 0.0014).

Conclusion: There seems to be no limitation of uterine volume in TLH for uterine leiomyomas because TLH is safer than TAH except for the longer surgical duration.




doi: http://dx.doi.org/10.4021/jcgo179w