Objective: Recently, pelviscopic hysterectomy has replaced the abdominal hysterectomy. There are lots of types of pelviscopic hysterectomy, that is, classic intrafascial Semm hysterectomy (CISH), total laparoscopic hysterectomy(TLH),
subtotal
laparoscopic hyterectomy(SLH) and laparoscopically assisted vaginal hysterectomy(LAVH). There are pros and cons about risks and safety of pelviscopic subtotal hysterectomy in women with benign gynecologic diseases. So we compared the results of
256
cases of CISH we'd experienced with the outcomes of comparable nember of cases of TAH to evaluate the advantages and safety of pelviscopic subtotal hysterecotmy. Methods: A retrospective study of 256 cases of CISH and 250 cases of TAH at
department of Obstetrics and Gynecology, Kyung-Hee University from November, 1995 to September, 2001. We compared the results each other with regard to the age, parity, past history of abdominal surgery, Ut. weight, other additional operations,
operation time, pathologic results, hospital days, blood loss and intra and postoperative complications. Results: the mean age of patients was 44.53±4.39 yrs in CISH, 43.27±4.71 yrs in TAH. The mean parity was 2.29±0.76 times in CISH,
2.32±0.81 times in TAH. The mean previous abdominal surgery hisotry was 0.78±0.55 tines in CISH, 0.95±0.71 times in TAH and there were no statistical significance(p>0.05). The mean Ut. weight was 191.90±83.37 gm in CISH, 451.70±89.01 gm in
TAH. The
mean operation time was 133.10±24.46 mins in CISH, 98.21±21.14 mins in TAH. The mean blood loss(Hb decline) was 1.12±0.91 gm/㎗ in CISH, 1.32±0.87 gm/㎗ in TAH. The mean complication rate was 7.81% in CISH, 12.40% in TAh and there all were
statistical significance(p<0.05). Conclusion: CISH has some advantages in hospitalization , Hb differences, complication rate over TAH but not in Ut. weight and operation time and is minimally invasive and organ-preserving surgery, also
this
may
expect to prevent the cervix cancer and will be efficient and safe operation substitutes for total abdominal hysterectomy in women with benign gynecologic diseases in the near future. We noticed that cervix is not a futile organ, so it should not
be
removed without proper indications.
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