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Histerectomia Vaginal Versus Histerectomia Abdominal Em Mulheres Sem Prolapso Genital, Em Maternidade-escola Do Recife: Ensaio Clínico Randomizado

A. Costa, M. R. Amorim, Telma Cursino
Published 2003 · Medicine

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PURPOSE: to compare intra- and postoperative results of vaginal hysterectomy with those of abdominal hysterectomy in women without genital prolapse or adnexal pathology. METHODS: a randomized, open clinical trial was conducted, involving 35 patients without genital prolapse scheduled for total hysterectomy due to benign disease, at IMIP, Recife, Brazil. These patients were randomly assigned to vaginal hysterectomy (19 patients) or abdominal hysterectomy (16 patients). Main outcome measures included estimated blood loss, rate of blood transfusion, duration of surgery, postoperative pain (intensity and analgesic requirement), time in hospital, postoperative complications, recovery time and patient satisfaction. Statistical analysis was performed using c2, exact Fisher and Mann-Whitney tests at a 5% level of significance. RESULTS: estimated blood losses were significantly lower in vaginal hysterectomy (median of 520 mL) than in abdominal hysterectomy (median 902 mL). There was no blood transfusion among patients of the vaginal hysterectomy group, in contrast to 19% of the abdominal hysterectomy group. Duration of surgery was similar (median of 120 min in both groups). Postoperative pain, as measured by visual analog scale and analgesic requirement, was lower for vaginal hysterectomy than for abdominal hysterectomy. There was no statistically significant difference regarding frequency of postoperative complications. There was one case of infection in each group and one case of thrombosis in the vaginal hysterectomy group. Postoperative hospital stay was shorter in the vaginal group. Recovery time was significantly shorter in the vaginal group (median of 35 days) versus the abdominal group (median 40 days). Overall patient satisfaction with the operation was similar in the two groups. CONCLUSIONS: patients without genital prolapse submitted to vaginal hysterectomy for treatment of benign diseases had some advantages in relation to those submitted to abdominal hysterectomy: lower intraoperative blood loss, lower postoperative pain and faster recovery time. Vaginal hysterectomy may replace abdominal hysterectomy in most patients who require hysterectomy.
This paper references
10.1016/S0029-7844(99)00641-9
Hysterectomy Outcomes in Patients With Similar Indications
S. R. Kovac (2000)
10.1016/0020-7292(95)90195-7
Hospital cost comparison between abdominal, vaginal, and laparoscopy‐assisted vaginal hysterectomies
C. Nezhat (1994)
10.1097/00006254-199508000-00012
Is Laparoscopic Hysterectomy a Waste of Time
R. Richardson (1995)
10.1016/S0002-9610(40)90259-8
Vaginal hysterectomy-its indications and technique
N. Heaney (1940)
10.1016/S0002-9378(99)70667-8
Prospective randomized clinical trial of laparoscopically assisted vaginal hysterectomy versus total abdominal hysterectomy.
T. Falcone (1999)
A simplified technique for abdominal panhysterectomy
EH Richardson (1940)
10.1016/S0029-7844(00)01232-1
Vaginal Route as the Norm When Planning Hysterectomy for Benign Conditions: Change in Practice
R. Varma (2001)
Randomized Comparison of Laparoscopy- Assisted Vaginal Hysterectomy With Standard Vaginal Hysterectomy in an Outpatient Setting
R. Summitt (1992)
10.1080/J.1600-0412.2001.080004337.X
Recovery from vaginal hysterectomy compared with laparoscopy-assisted vaginal hysterectomy: a prospective, randomized, multicenter study.
D. Soriano (2001)
10.1590/S0100-72031998000900008
Histerectomia vaginal: o laparoscópico é necessário?
O. F. Netto (1998)
10.1016/0002-9378(82)90362-3
Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States. The Collaborative Review of Sterilization.
R. Dicker (1982)
10.1016/S0002-9378(99)70199-7
Laparoscopically assisted vaginal hysterectomy versus total abdominal hysterectomy: a prospective, randomized, multicenter study.
R. Marana (1999)
10.1016/S0002-9610(02)00825-5
Innovation in surgery: the rules of evidence.
J. Meakins (2002)
Histerectomia vaginal em pacientes não portadoras de prolapso do útero: estudo de 370 casos
ALS Macedo (1995)
10.1056/NEJM199608153350705
Costs and charges associated with three alternative techniques of hysterectomy.
J. Dorsey (1996)
10.1097/00006250-199404000-00011
Hysterectomy in the United States, 1988‐1990
L. Wilcox (1994)
10.1016/S0029-7844(99)80026-X
Vaginal removal of the benign nonprolapsed uterus: experience with 300 consecutive operations.
O. Figueirêdo (1999)
10.1016/S0196-6553(99)70088-X
Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee.
A. Mangram (1999)
10.1016/S0002-9378(98)70207-8
How to increase the proportion of hysterectomies performed vaginally.
A. Davies (1998)
10.1111/j.1471-0528.1994.tb13583.x
A randomised prospective study of laparoscopic vaginal hysterectomy versus abdominal hysterectomy each with bilateral salpingo‐oophorectomy
K. Raju (1994)
10.1111/j.1471-0528.2000.tb11652.x
Three methods for hysterectomy: a randomised, prospective study of short term outcome
Christian Ottosen Consultant (2000)
10.1177/155335069900600207
Laparoscopic hysterectomy.
J. Hawe (1999)
Histerectomia vaginal sem prolapso : experiência inicial no IMIP
Amorim MMR (1999)
10.1016/S0301-2115(01)00341-4
Vaginal, laparoscopic, or abdominal hysterectomies for benign disorders: immediate and early postoperative complications.
M. Cosson (2001)
10.1016/S0301-2115(00)00339-0
Long term complications of vaginal hysterectomy: a case control study.
M. Cosson (2001)
Indicações atuais da cirurgia vaginal: experiência brasileira
SF Camargo (2001)



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