Surgical Site Infection in Laparoscopic Hysterectomy versus Abdominal Hysterectomy in Gynecological Disease(s): An Overview

Objective: Surgical site infection (SSI) is an unsettled complication seen in any surgery. The aim of this study is to assess the rate of postoperative SSIs between total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH). Can the rate of SSI be reduced with the use of a laparoscopic mode of hysterectomy over abdominal? Materials and Methods: It was a retrospective comparative study. The study was conducted in the obstetrics and gynecology department at a tertiary care center from June 2016 to March 2020. A total of 300 patients who underwent hysterectomy either via laparoscopic or abdominal route were included in the study. They were subdivided into two groups: a total of 167 underwent TLH (Group 1) and 133 had TAH (Group 2). The results were compared. It included the age and body mass index of the patient, indication of surgery, size of the uterus, intraoperative blood loss, postoperative SSIs, duration of hospital stay, and readmission rates. Results: It was found a high rate of SSI in TAH (82.4% vs. 17.6%, P < 0.001, Cramer's V-0.18), the operative time taken (75 +/- 25 min vs. 128 +/- 52 min, P < 0.001), and the mean blood loss during TLH (110 +/- 30 ml vs. 160 +/- 116 ml, P < 0.001) was found significant for patients. The hospital stay after TLH was found to be significantly shorter (4 +/- 2.47 days vs. 7 +/- 2.43, P < 0.001). Conclusion: TLH has improved the psychological, physical, and financial burden on the health care department. Thus, it has proved a preferred route over TAH.