Laparoscopic-assisted vaginal hysterectomy vs abdominal hysterectomy for benign disease: a meta-analysis of randomized controlled trials

Eur J Obstet Gynecol Reprod Biol. 2011 Nov;159(1):1-18. doi: 10.1016/j.ejogrb.2011.03.033. Epub 2011 Jun 12.

Abstract

The objective of this meta-analysis was to assess whether laparoscopic-assisted vaginal hysterectomy achieves better clinical results compared with abdominal hysterectomy. Medline (PubMed), EMBASE, Web of Science, ProQuest, Cochrane Library and China Biological Medicine Database were searched to identify randomized controlled trials that compared laparoscopic-assisted vaginal hysterectomy with abdominal hysterectomy. Twenty-three trials were studied and the analysis was performed using Review Manager Version 5 and R Version 2.11.1. The results showed that laparoscopic-assisted vaginal hysterectomy was associated with a longer operation time, less blood loss, shorter hospital stay, smaller haemoglobin drop, less postoperative pain, quicker return to normal activities and fewer peri-operative complications. Quality of life is likely to be the key outcome to evaluate the approach for hysterectomy, but further research is needed. For suitable patients and surgeons, laparoscopic-assisted vaginal hysterectomy is a better choice than abdominal hysterectomy.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Activities of Daily Living
  • Blood Loss, Surgical / prevention & control
  • Female
  • Humans
  • Hysterectomy / adverse effects
  • Hysterectomy / methods
  • Hysterectomy, Vaginal / adverse effects*
  • Laparoscopy / adverse effects*
  • Postoperative Complications / prevention & control
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Time Factors
  • Uterine Diseases / surgery*