Original Articles
Comparative analysis of non-descent vaginal hysterectomy versus total abdominal hysterectomy: A cross sectional study | |
Dr. Aradhana Radhakrishnan, Dr. Veena M Pillai, Dr. Minu Gopy, Dr. N S Sreedevi | |
Background: Hysterectomy is the most common major surgical procedure in gynecology. Today various approaches are available for performing hysterectomy. Vaginal and abdominal approaches represent the least and most invasive techniques respectively whereas the laparoscopic procedure remain in the middle of the spectrum. Non-descent Vaginal Hysterectomy (NDVH) is the removal of a non-prolapsed uterus through vagina.Once hysterectomy is decided, evidence-based guidelines should be assessed carefully to select the most appropriate route of surgery. The possibility of vaginal approach should be considered first followed by LAVH and lastly abdominal hysterectomy. Aims and Objectives 1. To determine feasibility, safety and patient comfort of non-descent vaginal hysterectomy. 2. Preoperative and postoperative comparison of non- descent vaginal hysterectomy and abdominal hysterectomy. Materials and Methods: The study was a cross sectional study conducted in the Institute of Maternal and Child Health, Medical College, Calicut for a period of 2 years. 100 patients requiring hysterectomy for gynecological disorders without prolapse were included in the study. In group A, (n=50), NDVH was performed and in group B (n=50) TAH was performed. Demographic variables, intraoperative blood loss and injuries, postoperative pain and complications and duration of hospital stay were compared between the two groups.Results: Of the 11 variables studied, 4 were found significant.Pain scoring on post-operative day 3, mean pain score in the NDVH group was 2.84 cm, while in the TAH group was 6.76 cm(pvalue-0.001). Mean duration of hospital stay was 5.5 day in the NDVH group while it was 7.4 days in the TAH group (p value 0,001). Incidence of wound infection in the TAH group was 11, no cases of wound infection was found in NDVH (p value-0.001). Twelve percent of patients in NDVH group and 30% patients in the TAH group had fever post-operatively (p value-0.048). Conclusion: Statistically significant decrease in the post-operative pain, wound infection, febrile morbidity and length of hospital stay occurred in the NDVH group compared to TAH group. There were no significant differences in the duration of surgery, blood loss, intraoperative injuries, post-operative bleeding needing re-laparotomy and post-operative blood transfusion between the two groups. |
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