To investigate clinical effects of modified total abdominal hysterectomy (MTAH), total laparoscopic hysterectomy (TLH) and trans-vaginal hysterectomy (TVH) on large uterus hysterectomy.

The retrospectively analysis were conducted on 88 cases who were underwent hysterectomy with size more than 12 pregnant weeks from January 2009 to January 2011. They were divided into three groups, MTAH group (n=36), TVH group (n=24) and TLH group (n=28). Operation time, bleeding volume, antibiotic administration time, rates of complications, bowel function recovery time, hospital-duration, hospital-cost, and pre- and post-operation effects were compared. Informed consent was obtained from all participates. There had no significant difference among three groups of age and operative procedure (same operation performer) (P>0.05).

The operation time, bleeding volume and hospital-cost in TLH group were more than those in TVH group and MTAH group with significant differences (P<0.05), without significant differences between those in TVH group and MTAH group (P>0.05). The antibiotic administration time in MTAH group was more than that in TVH and TLH groups with significant differences (P<0.05), without significant difference between that in TVH group and TLH group (P>0.05). The incidence rate of complications, bowel function recovery time and hospital-duration among three groups had no significant differences (P>0.05).

Three different operation procedures for total hysterectomy with size more than 12 pregnant weeks uterus have their own advantages and disadvantages. Considering the different condition of patients, hospital and technical levels, microinvasive and economical surgery should be chosen.