Single-port access versus conventional multi-port access total laparoscopic hysterectomy for very large uterus.
10.5468/ogs.2015.58.3.239
- Author:
Jinhwa LEE
1
;
Sunghoon KIM
;
Eun Ji NAM
;
Sun Mi HWANG
;
Young Tae KIM
;
Sang Wun KIM
Author Information
1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women's Cancer Clinic, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea. san1@yuhs.ac
- Publication Type:Original Article
- Keywords:
Hysterectomy;
Laparoscopy;
Neoplasms;
Uterus
- MeSH:
Adenomyosis;
Humans;
Hysterectomy*;
Laparoscopy;
Laparotomy;
Leiomyoma;
Length of Stay;
Pain, Postoperative;
Postoperative Hemorrhage;
Retrospective Studies;
Uterus*
- From:Obstetrics & Gynecology Science
2015;58(3):239-245
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The aim of this study was to compare the surgical outcomes of single-port access (SPA) and conventional multi-port access total laparoscopic hysterectomies (TLH) among patients with very large uteri (500 g or more). METHODS: Fifty consecutive patients who received TLH for large uterine myomas and/or adenomyoses weighing 500 g or more between February 2009 and December 2012 were retrospectively reviewed. SPA and conventional TLH were each performed in 25 patients. Surgical outcomes, including operation time, estimated blood loss, postoperative hemoglobin change, postoperative hospital stay, postoperative pain, and perioperative complications, were compared between the two groups. RESULTS: There were no significant demographic differences between the two groups. All operations were completed laparoscopically with no conversion to laparotomy. Total operation time, uterus weight, estimated blood loss, and postoperative hemoglobin change did not significantly differ between the two groups. Postoperative hospital stay was significantly shorter for the SPA-TLH group compared to that of the conventional TLH group (median [range], 3 [2.0-6.0] vs. 4 [3-7] days; P=0.004]. There were no inter-group differences in postoperative pain at 6, 24, and 72 hours after surgery. There was only one complicated case in each group. CONCLUSION: SPA-TLH in patients with large uteri weighing 500 g or more is as feasible as conventional TLH. SPA-TLH is associated with shorter hospital stays compared to that of conventional TLH.
