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Comparison of three approaches to hysterectomy for benign gynecologic disease

Comparison of three approaches to hysterectomy for benign gynecologic disease
Vaginal hysterectomy compared with abdominal hysterectomy
Shorter hospitalization (mean difference -1.07 days, 95% CI -1.22 to 0.92)
Speedier return to normal activities (mean difference -9.47 days, 95% CI -12.57 to -6.37)
Fewer infections or fevers (odds ratio 0.42, 95% CI 0.21-0.83)
Laparoscopic hysterectomy compared with abdominal hysterectomy
Less blood loss (mean difference 45.26 mL, 95% CI 17.85-72.68)
Shorter hospital stay (mean difference 2.01 days, 95% CI 1.86-2.17)
Speedier return to normal activities (mean difference 13.63 days, 95% CI 11.84-15.42)
Fewer wound infections or fevers (odds ratio 0.31, 95% CI 0.12-0.77)
Longer operating time (mean difference 20.27 minutes, 95% CI 3.95-36.59)
More urinary tract injuries (odds ratio 2.41, 95% CI 1.21-4.82)
Laparoscopic hysterectomy compared with vaginal hysterectomy
Similar outcomes except longer operating time (mean difference 39.29 minutes, 95% CI 38.72-39.86)
Total laparoscopic hysterectomy compared with laparoscopically assisted vaginal hysterectomy
Similar outcomes except longer operating time (mean difference 25.3 minutes, 95% CI 10-40.6)
Data from Nieboer TE, Johnson N, Lethaby A, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2009; 3:CD003677.
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