Peritoneal closure during laparoscopic supracervical hysterectomy

Holm Eggemann, Nara Asbahr Mitrik, Otto Kabdebo, Serban Dan Costa, Atanas Ignatov
In: Archives of Gynecology and Obstetrics · 2016 · vol. 294(4) , pp. 785–789 · doi:10.1007/s00404-016-4125-7 · PMID:27245666 · W2411635993
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Abstract

ObjectiveOur goal was to compare postoperative pain and analgesic requirements regarding closure and non-closure of the peritoneum in women undergoing laparoscopic supracervical hysterectomy (LSH).Study designA prospective cohort study was designed to investigate the impact of peritoneal closure for LSH. Postoperative pain was measured by a visual analogue scale (VAS) and analgesic requirements were assessed. Intra- and postoperative complications and operative time were recorded.ResultsA total of 104 patients were enrolled. Fifty-two (50 %) women underwent a LSH with peritoneal closure and 52 (50 %) underwent LSH without closure. The baseline characteristics were well balanced between the groups except for age; women undergoing LSH without peritoneal closure were significantly younger (p < 0.008, t test). The median operative time was 53 (26-105) minutes for LSH with peritoneal closure and 44 (24-83) minutes for LSH without peritoneal closure, a median reduction of 9 minutes (p = 0.007). No differences were found in uterine weight, intra- and post-operative complications, median haemoglobin drop or time in hospital when contrasting both groups. Both groups had similar VAS-pain scores and needed similar analgesic therapies.ConclusionsThe peritoneal closure at LSH provides no short-term postoperative advantages over a non-closure approach, and it prolongs the operative time and anaesthetic exposure. Our data suggest that peritoneal closure is not necessary in LSH.

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