Tehran University Medical Journal

Background: Over the past 50 years, subtotal or supracervical hysterectomy has come to be viewed as a suboptimal procedure reserved for those rare instances in which when concern over blood loss or anatomic distortion dictates limiting the extent of dissection, the aim of this study was to compare total and subtotal laparoscopic hysterectomy.
Methods: The patients who were candidates for hysterectomy with benign disease, with no contraindication for laparoscopic surgery entered the study in Arash Hospital, from March 2007 to April 2009. By simple randomization 45 patients (25 for TLH and 20 for SLH) were selected. Demographic Details and intra and post operative complications, were recorded by the staff and were compared between two groups.
Results: The average time for TLH operations look significantly longer than SLH operation (148.6±29.7 minutes 128.5±25.64 minutes, p=0.03). Although, the hemoglobin (gr/dl) drop in TLH was significantly higher than SLH (1.54 Versus 0.9, p<0.05) Blood transfusion were common in SLH (1 case Versus 3 Cases). The total length of hospital stay, was significantly shorter after SLH than TLH (3.6±1.47 day and 2.85±0.59, p=0.04). The drug requirements to control pain during hospitalization after both surgeries with analgesic injection were not significantly different, but with suppositories analgesic in SLH more than TLH. The time of return to normal activity was reported (p<0.0001) significantly shorter after SLH than TLH (13.12±18.1 and 5.04±1.79, p=0.0001). Sexual function had no significant difference between two groups but dysparunia in SLH was significantly lower than TLH (p=0.02). Cyclic bleeding and cervical prolaps, was not reported in two groups. Finally intra and post operative complications were more frequent in TLH.
Conclusions: SLH is a safe and effective surgery. Our data suggest that SLH can replace TLH in selected cases.