A Comparative Study Between Laparoscopically Assisted Vaginal Hysterectomy and Total Abdominal Hysterectomy in Patients with Type 2 Diabetes

Background: Laparoscopically assisted vaginal hysterectomy (LAVH) has become a popular alternative of total abdominal hysterectomy (TAH) in cases difficult to manage via the vaginal route alone among patients, with type 2 diabetes. Objective: The aim of this study was to compare the efficiency of LAVH with TAH in terms of operative time and cost, estimated blood loss, hospital stay, analgesics, intra- and postoperative complication rates and patient recovery time. Design: This was a retrospective study. Materials and Methods: The study design was a retrospective, nonrandomized analysis. A retrospective observational study in the Japan Bangladesh Friendship Hospital (JBF; Dhaka, Bangladesh) was carried out comparing LAVH and TAH among the patients with type 2 diabetes from August 2004 to July 2008. Operative time and cost, estimated blood loss, hospital stay, intra- and postoperative complication rates, patient recovery time, and hystopathology was summarized. One hundred and twenty (120) hospital charts were reviewed, 60 for patients undergoing LAVH and 60 for TAH. All statistical analyses were performed with commercially available software. Results: There was no significant difference in terms of age, parity, body weight, and prior pelvic surgery. There was no significant difference in operation time. There was a lesser amount of blood loss in the LAVH group. With regard to postoperative pain, significantly less diclofenac was required in the LAVH group. The postoperative hospital stay and time to return to work in the LAVH group were significantly shorter than the TAH group. Conclusions: LAVH is better than TAH for producing less pain, shorter length of hospital stay, and more rapid return to work in the case of patients with type 2 diabetes.