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Subject Area

Obstetrics and Gynecology

Article Type

Original Study

Abstract

Objective To compare surgical outcomes of abdominal hysterectomy (AH) versus total laparoscopic hysterectomy (TLH) in diabetic patients. Background Diabetes mellitus is considered a multisytemic disease affecting mainly the small vessels (diabetic vasculopathy). Diabetes mellitus and comorbidities associated with it are well-known factors that negatively affect surgical outcomes. Hysterectomy is one of the most frequent gynecological surgical procedure, having different routes, either abdominal, vaginal, or laparoscopic. AH is correlated to more complications such as wound infection and longer postoperative hospital stay in diabetic patients. However, TLH may be particularly well suited to diabetic women as they can avoid the postoperative complications and ensures more rapid recovery and shorter period of hospitalization than AH. Patients and methods This randomized controlled study was conducted at Tanta University from January 2017 till January 2021. One hundred and thirty cases were enrolled and randomly allocated into study (TLH) or control group (AH). Blood loss, operative time and postoperative complications were the study outcomes. Results There was no significant difference between both groups regarding age, BMI, glycemic control, or hemoglobin levels. Regarding surgical outcome, there was significant difference between both groups regarding the mean operative time in TLH versus AH and the intraoperative blood loss, and a highly significant difference as regards the postoperative need for analgesics and the length of hospital stay. Wound complications were minimal in TLH while severe complications occurred in AH. Conclusion TLH is superior to AH in diabetic women. Shorter hospital stay and good wound healing was highly superior in the TLH group.

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