| No statistical significance between complication rates for laproscopically assisted vaginal hysterectomy compared to total abdominal hsterectomy |
Citation/s:
American Journal Obstetrics and Gynaecology
Volume 180, Number 2 pp270-274
Lead author's name and fax: Riccardo Marana
Three-part Clinical Question: Are there more complications in
patients requiring laproscopically assisted vaginal hysterectomy compared with
total abdominal hysterectomy.
Search Terms: Medline search used. Terms used : Laproscopic
hysterectomy 102 citations Abdominal and laproscopic hysterectomies 28
citations
The Study:
Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Patients had to have one or more of the
following:- Uterine size 280g to 700g, previous pelvic surgery, history of
pelvic inflammatory disease, moderate or severe endometriosis, concomitant
adnexal masses or indication for adnexectomy, nulliparity with lack of uterine
descent and limited vaginal access.
Control group (N=58; 58 analysed): Total abdominal hysterectomy
Experimental group (N=58; 58 analysed): Laproscopically assisted
vaginal hysterectomy
The Evidence:
| Outcome | Time to Outcome | CER | EER | RRR | ARR | NNT |
| Major Complications | 0.034 | 0.017 | 50% | 0.017 | 59 | |
|---|---|---|---|---|---|---|
| 95% Confidence Intervals: | -100% to 100% | -0.040 to 0.074 | NNT=13 to INF; NNH=25 to INF | |||
| Minor Complications | 0.086 | 0.034 | 60% | 0.052 | 19 | |
| 95% Confidence Intervals: | -39% to 100% | -0.034 to 0.138 | NNT=7 to INF; NNH=29 to INF | |||
Comments:
Study also showed that there was no difference in operating time between
abdominal and laproscopically assisted hysterectomies. The intra-operative
blood loss and postoperative day 1 haemoglobin drop were less in the
laproscopic group. Postoperative pain and hospital stay were also reduced in
the laproscopic group.
Appraised by: Esther Moss Birmingham Women's Hospital Edgbaston; Thursday,
October 07, 1999
Email:
Kill or Update By: January 2000