Surgical blood loss and laparoscopic-assisted vaginal hysterectomy.

Objective: This study aimed to elucidate the possible relationship between surgical blood loss (SBL) and medical outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH).

Materials And Methods: Patients who underwent LAVH performed by the same surgeon for benign gynecologic diseases from 2004 to 2006 were analyzed retrospectively. Patients were divided into two groups according to the amount of SBL (< 150 mL or > or = 150 mL, 75th percentile of mean SBL). Clinical medical outcomes of all women were analyzed to identify the effects of SBL during LAVH.

Results: A total of 133 women with benign gynecologic disease were included. Group 1 (SBL < 150 mL) consisted of 108 patients and Group 2 (SBL > or = 150 mL) consisted of 25 patients. The mean operative time for patients with SBL > or = 150 mL was 36.1 minutes longer than that for patients with SBL < 150 mL (p < 0.001). Mean hospital stay, mean shift in serum hemoglobin, mean shift in serum hematocrit and mean flatulence relief time were not significantly different between the two groups.

Conclusion: Greater SBL (> or = 150 mL) during LAVH was significantly associated with longer operating time, but had no detrimental effect on short-term surgical outcomes. Thus, efforts to minimize intraoperative bleeding and so reduce operative time will be beneficial for women undergoing LAVH.