Study objective:
To compare length of hospital stay for minilaparotomy vs laparoscopic hysterectomy.
Design:
Retrospective cohort study (canadian task force classification ii-2).
Setting:
Kaiser permanente northern california, a large integrated health care delivery system.
Patients:
Women >18 years of age undergoing laparoscopic or minilaparotomy hysterectomy because of benign indications from june 2009 through january 2010.
Intervention:
Hysterectomy via minilaparotomy or laparoscopy.
Measurements and main results:
Medical records were reviewed for outcomes of interest including length of stay and surgical and demographic data. parametric and non-parametric analyses were used to compare the 2 groups. the study was powered to detect a difference of 8 hours in length of stay. two hundred sixty-three cases were identified as hysterectomy via minilaparotomy (n = 100) or laparoscopy (n = 163). the laparoscopy group demonstrated a significantly shorter mean (sd) length of stay (19 [14] hours vs. 42 [20] hours; p < .001) and less blood loss (126 [140] ml vs. 241 [238] ml; p < .001). the minilaparotomy group experienced a shorter procedure time (113 [47] minutes vs. 197 [124] minutes; p < .001). there was no difference between the groups insofar as patient morbidity including intraoperative and postoperative complications, emergency visits, readmissions, or repeat operations.
Conclusion:
Compared with minilaparotomy, laparoscopic hysterectomy is associated with shorter length of hospital stay, longer operating time, and no increased patient morbidity.