Minilaparotomy versus conventional laparotomy for abdominal hysterectomy for benign gynecologic disease : A comparative study

Abstract

Background : Hysterectomy is the most common gynecologic operation for treatment benign cervical, uterine and ovarian disease, and treatment malignant gynecologic disease such as early stage of cervical cancer, uterine cancer and ovarian cancer. Hysterectomy can be performed by different approaches like abdominal, vaginal and laparoscopic. Gynecological endoscopy have become popular because  smaller incision , less postoperative recovery time, shorter hospital stay and improve quality of life but has some limits for laparoscopic surgery. Minilaparotomy hysterectomy is the other choice for treatment benign gynecologic disease and outcomes are not different from conventional hysterectomy.

Objective : Comparison of minilaparotomy abdominal hysterectomy with conventional hysterectomy in clinical outcomes ,intra- and post-operative and complications..

Material and  Methods : To compare outcomes of 70 cases of conventional abdominal hysterectomy(group I, incision > 6 cm) and outcomes 65 cases of minilaparotomy hysterectomy (group II,incision < 6 cm) performed from January 2014 to December 2016

Result : Mean age was 45 years in group I , was 46.9 years in group II and parity was 1.92 in group I , was 2 in group II, estimated blood loss was higher in group I (367 ml) than group II(336 ml). Mean operative time was 56 minutes in group I less than group II spent 61 minutes Mean postoperative hospitalization was 3.3days in group I more than group II was 2.8 days, mean postoperative pain in group I was 5.2 and group II was 4.3. Use of postoperative analgesic drug in group I was 38 mg was 12 mg in group II, no intraoperative complications in 2 groups, postoperative complications was 2 cases (2.8 %) of wound infection in group I and 1 case (1.5 %) of urinary tract infection in group II

Conclusion : Minilaparotomy hysterectomy was safe and feasible in women undergoing hysterectomy for benign gynecologic disease, it should be considered as alternative to conventional abdominal hysterectomy