Laparoscopic hysterectomy versus abdominal hysterectomy for severe pelvic endometriosis

ObjectiveTo compare the surgical outcomes of laparoscopic hysterectomy (LH) versus abdominal hysterectomy (AH) in patients with severe pelvic endometriosis.MethodsA retrospective review of patients undergoing hysterectomy for endometriosis was conducted between January 2002 and December 2007. A total of 503 patients had severe pelvic endometriosis; of these, 115 patients underwent LH and 388 patients underwent AH. Surgical outcomes—including operative time, blood loss, length of hospital stay, and need for blood transfusion—were analyzed and compared between the 2 treatment groups.ResultsOperative time was significantly longer for LH than for AH (185.1 ± 48.7 minutes and 139.9 ± 52.4 minutes, respectively; P < 0.001). However, estimated volume of blood loss, length of hospital stay, and complication rates were significantly less for patients in the LH group than for those in the AH group (302.6 ± 255.1 mL versus 760.9 ± 633.2 mL [P < 0.001]; 3.5 ± 1.1 days versus 6.4 ± 3.0 days [P < 0.001]; and 18.3% versus 49.0% [P < 0.001], respectively).ConclusionCompared with AH, LH was associated with fewer complications. LH should, therefore, be the preferred surgical option for women with severe pelvic endometriosis who require a hysterectomy.