Total laparoscopic hysterectomy (TLH) versus coagulation of uterine arteries (CUA) at their origin plus total laparoscopic hysterectomy (TLH) for the management of myoma and adenomyosis

Abstract

We tried to evaluate the relative feasibility, surgical duration and complications of total laparoscopic hysterectomy (TLH) versus coagulation of uterine arteries at their origin (CUA) plus total laparoscopic hysterectomy for the management of myoma and adenomyosis, and to compare the estimated blood loss for both procedures. A total of 123 patients underwent TLH or CUA plus TLH for the treatment of symptomatic myoma and adenomyosis. Sixty‐four women underwent TLH, whilst 68 women underwent coagulation of uterine arteries at their origin plus TLH. The mean weight and volume of the uterus as determined following TLH was 288.1±102.4gm (range 182.1∼396.2gm.) and 451±340.6cm³ (range 107.4 ∼ 792), respectively. The mean weight of the uterus following CUA plus TLH was 269.1±151.7gm (range 215.8∼430.1) whilst the mean uterine volume was 472.7±377.8cm³ (range 93.7 ∼ 851.2). No significant differences with respect to surgical duration (95 vs. 96.5 minutes TLH vs. CUA + TLH; p>0.05), blood loss (177.2±80.1ml for TLH and 154.9±30.21ml for CUA+TLH; p>0.05) and mean±SD preoperative (12.05±1.70gm/dl for TLH and 12.14±1.38gm/dl for CUA+TLH; p>0.05) and post‐operative hemoglobin level (11±1.03 for TLH and 11±1.49 for CUA + TLH; p>0.05) were observed between the two study groups. The blood loss for TLH is comparable to that for the CUA plus TLH procedure.

• Total laparoscopic hysterectomy
• coagulation of uterine arteries
• leiomyoma
• adenomyosis

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