Shorter Stays, No Increased Complications with Laparoscopic vs Vaginal Hysterectomy, Study Shows

   According to a study presented at the American College of Obstetricians and Gynecologists’ 59th Annual Clinical Meeting in Washington, D.C., compared to vaginal hysterectomy, laparoscopic hysterectomy resulted in shorter hospital stays and no evidence of increased complications with increased uterine weights.

   There had been no large study comparing laparoscopic to vaginal hysterectomies in American institutions before Annika  R. Malmberg, MD, and colleagues at Kaiser Permanente East Bay Oakland Medical Center in Oakland, California, evaluated the lengths of stay for the two procedures. They performed a retrospective cohort study including all healthy adults undergoing either procedure for benign indications in the Kaiser Permanente Northern California system from 2008 to 2010. The primary outcome was length of stay; secondary outcomes included complications, surgical time, blood loss, uterine weights, and patient demographics.

   The researchers’ preliminary analysis of an initial cohort of 400 randomly selected charts demonstrated a significantly shorter hospital stay and less blood loss for laparoscopic compared with vaginal hysterectomies (P</=0.05). The average length of stay for the laparoscopic procedure was 10 hours compared with 26 hours for the vaginal hysterectomy. Complication rates were minimal and without significant difference. But the laparoscopic group trended toward longer surgical time and increased uterine weights.