Laparoscopic subtotal hysterectomy versus laparoscopic total hysterectomy – a retrospective study of 2082 cases

Introduction:

At present, the comparison of the laparoscopic subtotal hysterectomy (LSH) and laparoscopic total hysterectomy (LH) as surgical approach remains a topic of controversy with only limited outcome and subjective health perception data available. We performed a retrospective trial to analyze the intra- and postoperative outcomes, as well as patient quality of life and sexual function in women undergoing LSH and LH for benign uterine disease.

Method:

A total of 2299 laparoscopic hysterectomies performed between January 2003 and April 2010at the University Women's Hospital in Tübingen were included in the present study. Patient baseline characteristics, intra- and postoperative complications, operating time and duration of hospital stay were retrospectively assessed. Furthermore, in order to assess postoperative quality of life and sexual function standardized questionnaires were sent to patients. After univariate statistical analysis logistic regression models were investigated to identify prognostic factors for conversion to laparotomy respectively severe complications.

Preliminary Results: A total of 1131 (49.2%) cases of laparoscopic hysterectomies were so far analyzed, 965 (85.3%) cases of LSH and 166 (14.7%) cases of LH. The main indications for surgery were uterine leiomyomas in both treatment groups, 62.5% in the LSH group and 54.8% in the LH group. Mean operating time for LSH was 99min (95% CI 97min-102min) compared to 115min (95% CI 108min-122min) for LH (*p-value <0.001*). Overall conversion rate to laparotomy in LSH cases was 2.9% compared to a laparotomy conversion rate of 11.4% in LH cases (*p-value <0.001*).

Discussion:

Completed data with long and short term complications as well as long term patient follow-up data with quality of life and sexual function analysis will be presented at the congress.