Clinical Comparison Of Transvaginal Hysterectomy And Total Abdominohysterectomy

Objective : To evaluate the feasibility, clinical effect and safety of transvaginal hysterectomy, and compare the advantage and unadvantage of transvaginal hysterectomy and total abdominohysterectomy.Methods: From January 2005 to April 2007, Retrospective analysis complications of 680 hysterectomy during a three-year period in Department of Obstetrics and Gynecology, Tongliao professional institute affiliated hospital and Race University affiliated hospital, 340 cases treated by transvaginal hysterectomy were analyzed as the study group, and 340 cases treated by total abdominohysterectomy during the same period in our hospital were selected as the control group. Operation time, blood loss, baseline characteristics, and complication were recorded. Effects of operating and recovery of two groups were compared. Retrospectively study all the patients without uterine prolapsein whom hysterectomy with or without adnexectomy was indicated in the general hospital in the past three years.Results: There were no significant differences in the mean of the patients' ages (45.17 vs 45.28), the uterine weight (103±5 vs114±2) between study group and control group. . There were significant differences in the mean operating time (58.69min vs 81.12min), blood loss (120.55ml vs 188.99ml) during operation between the study group and the control group. In the study group, the mean recovery time of bowel function is 25.02 hours and average postoperative hospital stay is 4.93 days and mean expenses for operation and hospitalization is 2258.90 yuan. They were shorter than in the control group (44.65 hours, 7.57days, 2776.07 yuan). For two groups, menorrhagia were relieved after 6.8months follow-up, patients in the study group recovered more rapidly and felt more satisfactory with the effect of operation than patients in the control group.Conclusion: Transvaginal hysterectomy can be performed in selected patients with minimum operative injury, low complications and good short-time effect compared with total abdominohysterectomy. Vaginal hysterectomy should be the primary route for the hysterectomy in the patients with benign disease and initial malignant tumor because of the minimal invasion. An average practicing gynecologist can increase his/her vaginal hysterectomy rate more than 90% within three years without increasing complication.