Comparative Perioperative Outcomes of Laparoscopic and AH for Benign Gynecological Disease: A Multicenter Retrospective Cohort Study.

BackgroundMinimally invasive hysterectomy has increasingly replaced AH for benign gynecologic disease. This multicenter study evaluated perioperative and short-term outcomes associated with laparoscopic versus AH for benign gynecologic disease.MethodsThis multicenter retrospective cohort study was conducted across three tertiary institutions in Pakistan from 2019 to 2024. Adult women undergoing elective hysterectomy for benign indications were included. Multivariable regression models adjusted for baseline covariates.ResultsA total of 400 patients were included (laparoscopic n = 200; abdominal n = 200). Laparoscopic hysterectomy was associated with lower estimated blood loss, fewer postoperative complications, and shorter hospital stay, although operative duration was longer. After multivariable adjustment, AH remained independently associated with increased odds of postoperative complications and prolonged hospitalization.ConclusionsIn this multicenter cohort, laparoscopic hysterectomy was associated with improved perioperative outcomes and shorter hospitalization compared with AH. Prospective studies are warranted to further define comparative effectiveness across diverse healthcare settings.