Comparison of laparoscopic, abdominal, and vaginal hysterectomy methods in terms of clinical parameters

Year 2025, Volume: 16 Issue: 56, 162 - 167, 16.12.2025

İlkan Kayar , Ferhat Çetin , Mustafa Çetin , Özer Birge

https://doi.org/10.17944/interdiscip.1772824

Abstract

Objective: To compare the demographic characteristics, operative outcomes, laboratory findings, and complications among laparoscopic (n=254), abdominal (n=233), and vaginal (n=334) hysterectomy methods.
Methods: A retrospective analysis of 821 patients undergoing hysterectomy was conducted. Groups were compared for age, BMI (body mass index), operative time, intraoperative blood loss, postoperative hemoglobin drop (ΔHb), length of hospital stay, complication rates, wound infections, and presence of malignancy. Statistical significance was assessed with p < 0.05, and post-hoc analyses were adjusted accordingly.
Results: Mean age differed significantly among groups (p < 0.001), notably between laparoscopic (48 ± 6 years) and vaginal (50 ± 6 years) groups (adj. p < 0.001); BMI showed no significant difference (p = 0.089). Operative time was longest in the laparoscopic group (95 ± 14 min, p < 0.001, all post-hoc adj. p < 0.001). Blood loss was highest in the abdominal group (253 ± 67 cc) compared to laparoscopic (123 ± 40 cc) and vaginal (135 ± 37 cc) (p < 0.001, adj. p < 0.001). The postoperative hemoglobin decrease was greatest in the abdominal group (–2.73 ± 1.54 g/dL) versus laparoscopic (–1.58 ± 1.11 g/dL) and vaginal (–1.73 ± 0.97 g/dL) (p < 0.001, adj. p < 0.001). Hospital stay was shortest after vaginal hysterectomy (2.0 ± 0.5 days) and longest after abdominal (3.1 ± 0.8 days) (p < 0.001, adj. p < 0.001). Complication rate was highest in the abdominal group (16.3%), including wound infection (10.3%) (p < 0.001). Malignant pathology was more frequent
in the abdominal group (9.0%) compared to vaginal (3.3%) (p = 0.013).
Conclusion: Abdominal hysterectomy is associated with greater blood loss, larger hemoglobin drop, longer operative time and hospital stay, and higher complication and malignancy detection rates, whereas vaginal hysterectomy offers the shortest hospitalization. These findings underscore the importance of surgical method selection based on perioperative risk profiles.

Keywords

Hysterectomy , laparoscopic hysterectomy , abdominal hysterectomy , vaginal hysterectomy , operative outcomes

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