Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China

摘要

Background: To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy(LH) compared with abdominal hysterectomy(AH) in case of benign gynecological disease. Methods: A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies(3,539 LH vs.1,356 AH) between 2007 and 2013 was involved. Operative time(OT), estimated blood loss(EBL), intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed.Results: The EBL(174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively), passing flatus(38.7±14.1 vs. 48.1±13.2 hours), days with indwelling catheter(1.5±0.6 vs. 2.2±0.8 days), use of analgesics(6.5% vs. 73.1%), intra-operative complication rate(2.4% vs. 4.1%), post-operative complication rate(2.3% vs. 5.7%), post-operative constipation(12.1% vs. 24.6%), mild and serious stress urinary incontinence(SUI) post-operative(P<0.001; P=0.014), and proportion of Female Sexual Functioning Index(FSFI) total score <26.55 post-operative(P<0.001) of the LH group were significantly less than those of AH group. There wereno significant differences in OT(106.5±34.5 vs. 106.2±40.3 min) between the two groups.Conclusions: LH is a safe and efficient operation for improving patients' long-term quality of life(Qo L), and LH is a cost-effectiveness procedure for treating benign gynecological disease. LH is superior to AH due to reduced EBL, reduced post-operative pain and earlier passing flatus.