A comparison of closed and open vaginal vault closure during abdominal hysterectomy

Closed vs. open vaginal vault in abdominal hysterectomy

Abstract

Introduction: Hysterectomy is one of the most frequently performed major surgical procedures. Majority of the hysterectomies are still done by the means of abdominal route. Despite its common performance, there is no grade A recommendations or guidelines regarding the closure of the vaginal vault after hysterectomy, either closing or opening the vaginal vault.

Method: This was a retrospective study done at Patan Hospital involving patients with total abdominal hysterectomy from January 2018 to December 2020. Data were collected from medical record. Data were compared for duration of hospital stay, febrile morbidity, vault hematoma, vaginal bleeding, relaparotomy between two groups of patients with either closed or open vaginal vault after abdominal hysterectomy. Ethical approval was obtained. The independents sample t-test was used and Chi-square tests were used. A p value of <0.05 considered statistically significant.

Result: Of the 280 patients, 205(73.2%) had closed vaginal vault whereas 75(26.8%) had vault open. Mean hospital stay was 7.93±3.108 d. Closed and open vaginal vault techniques did not differ in terms of length of hospital stay (7.83 vs. 8.19 days; p=0.40), febrile morbidity (54.6% vs. 52%; p=0.695). Pelvic hematoma with vaginal spotting was noticed in two (0.71%) cases of closed vaginal vault.

Conclusion: Both techniques of closed vs. open vaginal vault after hysterectomy gave similar outcomes regarding length of hospital stay, and postoperative complications.

Keywords: Hysterectomy, closed vaginal vault closure, open vaginal vault closure