Minilaparotomy vs. laparoscopic hysterectomy: comparison of length of hospital stay

Study objective: To compare length of hospital stay for minilaparotomy vs laparoscopic hysterectomy.

Design: Retrospective cohort study (Canadian Task Force classification II-2).

Setting: Kaiser Permanente Northern California, a large integrated health care delivery system.

Patients: Women >18 years of age undergoing laparoscopic or minilaparotomy hysterectomy because of benign indications from June 2009 through January 2010.

Intervention: Hysterectomy via minilaparotomy or laparoscopy.

Measurements and main results: Medical records were reviewed for outcomes of interest including length of stay and surgical and demographic data. Parametric and non-parametric analyses were used to compare the 2 groups. The study was powered to detect a difference of 8 hours in length of stay. Two hundred sixty-three cases were identified as hysterectomy via minilaparotomy (n = 100) or laparoscopy (n = 163). The laparoscopy group demonstrated a significantly shorter mean (SD) length of stay (19 [14] hours vs. 42 [20] hours; p < .001) and less blood loss (126 [140] mL vs. 241 [238] mL; p < .001). The minilaparotomy group experienced a shorter procedure time (113 [47] minutes vs. 197 [124] minutes; p < .001). There was no difference between the groups insofar as patient morbidity including intraoperative and postoperative complications, emergency visits, readmissions, or repeat operations.

Conclusion: Compared with minilaparotomy, laparoscopic hysterectomy is associated with shorter length of hospital stay, longer operating time, and no increased patient morbidity.