Rate of major complications is higher in laparoscopic than abdominal hysterectomy but quality of life improves with both procedures

Question

Is the risk of major complications greater following laparoscopic hysterectomy compared with abdominal and vaginal hysterectomy for non-malignant conditions?

Study design

Two parallel, multi-centre randomised trials.

Main results

More major complications were experienced with laparoscopic hysterectomy compared with abdominal hysterectomy (11.1% vs 6.2%; mean difference 4.9%, 95% CI 0.9% to 9.1%, number needed to harm 20). There was no significant difference in complication rates between laparoscopic and vaginal hysterectomy groups (complication rate 9.5% for both groups).

Pain scores were higher following abdominal hysterectomy compared with laparoscopic hysterectomy (mean difference 0.4, 95% CI 0.09 to 0.7). There was no detectable difference in the vaginal trial. Quality of life at 12 months improved with all interventions.

Authors’ conclusions

Major complications were more common following laparoscopic hysterectomy compared with abdominal hysterectomy. The vaginal trial was inconclusive.