Page 35 - World Journal of Laparoscopic Surgery

A Comparative Evaluation of Total Laparoscopic Hysterectomy and Laparoscopic Supracervical Hysterectomy
The incidence of postoperative vaginal bleeding was 13.3% in randomised controlled trial. Lancet 2019;394(10207):1425–1436. DOI:
the LSH group in our study which is as per previous studies. Ghomi 10.1016/S0140-6736(19)31790-8.
3
18
et al. and Lieng et al. reported the overall incidence of post-LSH 5. Johnson N, Barlow D, Lethaby A, et al. Surgical approach to
vaginal bleeding as 19 and 0–25%, respectively. hysterectomy for benign gynaecological disease. Cochrane Database
Syst Rev 2006;3:CD003677. DOI: 10.1002/14651858.CD003677.pub4.
19
Hellstrom et al. described that the risk of development of 6. Jenkins TR. Laparoscopic supracervical hysterectomy. Am J Obstet
carcinoma in the cervical stump is similar to the general population. Gynecol 2004;191(6):1875–1884. DOI: 10.1016/j.ajog.2004.06.096.
In India, the incidence of carcinoma cervix is quite high and this 7. Zupi E, Zullo F, Marconi D, et al. Hysteroscopic endometrial resection
was the probable reason behind the small sample size in our study. versus laparoscopic supracervical hysterectomy for menorrhagia: a
Routine cytological screening must be continued following a prospective randomized trial. Am J Obstet Gynecol 2003;188(1):7–12.
supracervical hysterectomy because of the persistent risk. DOI: 10.1067/mob.2003.60.
Prospective nature and randomization were strengths of the 8. Lethaby A, Mukhopadhyay A, Naik R. Total versus subtotal
study. However, larger sample size and longer follow-up period hysterectomy for benign gynaecological conditions. Cochrane
would have produced more robust results and these are some Database Syst Rev 2012;4:CD004993. DOI: 10.1002/14651858.
CD004993.pub3.
limitations of the present study. 9. Cipullo L, Paoli SD, Fasolino L, et al. Laparoscopic supracervical
To the best of our knowledge, this is the first study from India hysterectomy compared to total hysterectomy. JSLS 2009;13(3):370–375.
comparing LSH with TLH. We postulate based on current data that 10. Einarsson J, Suzuki Y, Vellinga TT. Intramyometrial injection of
supracervical hysterectomy has no added advantages over a total vasopressin in laparoscopic supracervical hysterectomy. J Minim
hysterectomy in terms of intraoperative and postoperative outcome Invasive Gynecol 2008;15(2):197–201. DOI: 10.1016/j.jmig.2007.12.002.
measures as well as bladder, bowel, and sexual functions and in a 11. Boosz A, Lermann J, Mehlhorn G, et al. Comparison of re-operation
country like India, where background incidence of carcinoma cervix rates and complication rates after total laparoscopic hysterectomy
is high, the decision should be individualized. (TLH) and laparoscopy-assisted supracervical hysterectomy (LASH).
Eur J Obstet Gynecol Reprod Biol 2011;158(2):269–273. DOI: 10.1016/j.
ejogrb.2011.04.021.
conclusion 12. El-Mowafi D, Madkour W, Lall C, et al. Laparoscopic supracervical
Laparoscopic supracervical hysterectomy is safe and efficacious as hysterectomy versus laparoscopic-assisted vaginal hysterectomy. J
TLH for benign uterine pathologies but has no extra benefits rather Am Assoc Gynecol Laparosc 2004;11(2):175–180. DOI: 10.1016/s1074-
3804(05)60194-6.
associated with a persistent risk of developing cervical diseases 13. Mueller A, Renner SP, Haeberle L, et al. Comparison of total
and malignancy. laparoscopic hysterectomy and laparoscopy-assisted supracervical
hysterectomy in women with uterine leiomyoma. Eur J Obstet Gynecol
orcid Reprod Biol 2009;144(1):76–79. DOI: 10.1016/j.ejogrb.2009.02.004.
14. Ozgur H, Elena T, Sertac E, et al. A comparison of short-term outcomes
Kavita Khoiwal: https://orcid.org/0000-0002-3516-7486 between laparoscopic supracervical and total hysterectomy. Am J Obstet
Gynecol 2009;201(5):536.e1–536.e7. DOI: 10.1016/j.ajog.2009.07.048.
15. Kafy S, Al-Sannan B, Kabli N, et al. Patient satisfaction after
references laparoscopic total or supracervical hysterectomy. Gynecol Obstet
1. Desai S, Shuka A, Nambiar D, et al. Patterns of hysterectomy in India: a Invest 2009;67(3):169–172. DOI: 10.1159/000184679.
national and state-level analysis of the Fourth National Family Health 16. Einarsson JI, Suzuki Y, Vellinga TT, et al. Prospective evaluation of
Survey (2015–2016). BJOG 2019;126(S4):72–80. DOI: 10.1111/1471- quality of life in total versus supracervical laparoscopic hysterectomy.
0528.15858. J Minim Invasive Gynecol 2011;18(5):617–621. DOI: 10.1016/j.
2. Nieboer TE, Johnson N, Lethaby A, et al. Surgical approach to jmig.2011.06.003.
hysterectomy for benign gynaecological disease. Cochrane 17. Berlit S, Tuschy B, Wuhrer A, et al. Sexual functioning after total
Database Syst Rev 2009;3:CD003677. DOI: 10.1002/14651858. versus subtotal laparoscopic hysterectomy. Arch Gynecol Obstet
CD003677.pub4. 2018;298(2):337–344. DOI: 10.1007/s00404-018-4812-7.
3. Lieng M, Qvigstad E, Istre O, et al. Long-term outcomes following 18. Ghomi A, Hantes J, Lotze EC. Incidence of cyclical bleeding after
laparoscopic supracervical hysterectomy. BJOG 2008;115(13):1605– laparoscopic supracervical hysterectomy. J Minim Invasive Gynecol
1610. DOI: 10.1111/j.1471-0528.2008.01854.x. 2005;12(3):201–205. DOI: 10.1016/j.jmig.2005.03.008.
4. Cooper K, Breeman S, Scott NW, et al. Laparoscopic supracervical 19. Hellstrom AC, Sigurjonson T, Pettersson F. Carcinoma of the cervical
hysterectomy versus endometrial ablation for women with heavy stump. The radiumhemmet series 1959–1987. Treatment and
menstrual bleeding (HEALTH): a parallel-group, open-label, prognosis. Acta Obstet Gynecol Scand 2001;80(2):152–157.

World Journal of Laparoscopic Surgery, Volume 14 Issue 1 (January–April 2021) 33