Comparative Study between Non Descent Vaginal Hysterectomy and Abdominal Hysterectomy- A Prospective Study
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2017, Vol 2, Issue 5
Abstract
Hysterectomy is the most common major gynaecological surgery. Can be done by abdominal or vaginal route or laparoscopically. Laparoscopically assisted vaginal hysterectomy (LAVH) is increasing,but is costly, takes longer time and needs expertise. Vaginal route should be used for indications other than prolapse. Only limitatation of NDVH, large sized uterus, can be overcome by morcellation, bisection etc.Vaginal hysterectomy has less febrile morbidity, less bleeding , shorter stay and faster convalescence than abdominal hysterectomy. Material and Methods: 100 patients with benign uterine disorders enrolled and divided in to two groups. Group A: 50 patients underwent NDVH. Group B: 50 patients underwent total abdominal hysterectomy. All were given prophylactic antibiotics, done under combined spinal epidural anaesthesia . NDVH was done by 1.Using clamps2. Clampless. Diclofenac sodium 50 mg im given before leaving theatre, 2 more doses given 8 hrs apart. Results and discussion: (1.) Intraoperative injury: Bladder (4% of TAH) and NDVH (no injury), p value 0.153, not significant. (2) Blood transfusion: NDVH (1), TAH( 4) , p value 0. 169, not significant. (3) Mean Hb Fall: NDVH (Preoperative Hb 10.64 gms%, Postoperative10.32 gms% ). TAH (Preoperative 11.44 gms% , postoperative 9.68 gms% ) Difference statistically significant, p value 0.0061. (4) Mean duration of surgery: 91+/-24.83 minutes (NDVH), 137.55+/-30.8 min (TAH),p value <0.001 Significant. (5) Mean Blood loss 98.8+/-43.34 ml (NDVH) , 240.0+/-166.17ml ( TAH) p value <0.001 Significant. (6) Mean post-operative stay 3.38+/-0.99 days (NDVH) and 5.89+/-4.11 days (TAH) p value <0.001, significant. (7) Pain: 1.28/-2.27 (NDVH) , 5.75+/- 2.24 (TAH) p value <0.0001 ,highly significant.(8) Mean No. of threads used 3.22+/-0.42(NDVH) and 4.75+/-0.71(TAH ) p value<0.0001 statistically highly significant. Conclusion: NDVH is safe, feasible, and cost effective and provides more comfort to patient without increasing duration of surgery, blood loss, intraoperative and postoperative complications.
Authors and Affiliations
Dr Rosy Bansal
Keywords
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