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Hysterectomy costs depending on operational technique
Affiliations- Department of Obstetrics and Gynecology with Gynecological Oncology Subdivision, Brothers Hospitallers of Saint John of God Hospital, Katowice, Poland
- The Chair of Woman’s Health, The Medical University of Silesia in Katowice, Poland
open access
Abstract
Objectives: The aim of the study was to perform a comparative analysis of hysterectomy costs versus the operative technique based on the data of 656 patients operated at the Department of Obstetrics and Gynecology with Gynecological Oncology Subdivision, Brothers Hospitallers of Saint John of God Hospital, Katowice, between 2016 and 2018 (until May 31, 2018).
Material and methods: This retrospective research involved 656 patients who underwent hysterectomy for non-oncological reasons. The patients were subdivided into three groups, depending on the operative method (transabdominal, laparoscopic or transvaginal). Next, treatment costs were compared, including the costs of hospitalization, operating block, operating block materials, drugs, anesthesia, and medical staff. The duration of the operation and the hospital stay were also analyzed as they significantly affected the final result.
Results: Data analysis revealed that transvaginal hysterectomy generated the lowest costs. A positive relationship between low costs and the duration of surgery and hospitalization, which is significantly shortened in case of transvaginal hysterectomy, was confirmed.
Conclusions:
1. The transvaginal approach is the most cost-effective technique of hysterectomy.
2. Apart from the financial advantage, transvaginal hysterectomy is also associated with shorter hospitalization and faster recovery.
3. Emphasis should be placed on training physicians in minimally invasive hysterectomies — especially the transvaginal approach — so that the greatest percentage of patients who are deemed eligible for hysterectomy could be operated using this minimally invasive technique.
Abstract
Objectives: The aim of the study was to perform a comparative analysis of hysterectomy costs versus the operative technique based on the data of 656 patients operated at the Department of Obstetrics and Gynecology with Gynecological Oncology Subdivision, Brothers Hospitallers of Saint John of God Hospital, Katowice, between 2016 and 2018 (until May 31, 2018).
Material and methods: This retrospective research involved 656 patients who underwent hysterectomy for non-oncological reasons. The patients were subdivided into three groups, depending on the operative method (transabdominal, laparoscopic or transvaginal). Next, treatment costs were compared, including the costs of hospitalization, operating block, operating block materials, drugs, anesthesia, and medical staff. The duration of the operation and the hospital stay were also analyzed as they significantly affected the final result.
Results: Data analysis revealed that transvaginal hysterectomy generated the lowest costs. A positive relationship between low costs and the duration of surgery and hospitalization, which is significantly shortened in case of transvaginal hysterectomy, was confirmed.
Conclusions:
1. The transvaginal approach is the most cost-effective technique of hysterectomy.
2. Apart from the financial advantage, transvaginal hysterectomy is also associated with shorter hospitalization and faster recovery.
3. Emphasis should be placed on training physicians in minimally invasive hysterectomies — especially the transvaginal approach — so that the greatest percentage of patients who are deemed eligible for hysterectomy could be operated using this minimally invasive technique.
Keywords
hysterectomy; operation; costs
About this articleTitle
Hysterectomy costs depending on operational technique
Journal
Issue
Article type
Research paper
Pages
672-676
Published online
2018-12-28
Page views
2012
Article views/downloads
1421
DOI
Pubmed
Bibliographic record
Ginekol Pol 2018;89(12):672-676.
Keywords
hysterectomy
operation
costs
Authors
Ewa Kala
Rafal Stojko
Marcin Sadlocha
References (18)- Committee Opinion No. 701. The route of hysterectomy for benign disease. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017; 129: e155–9.
- Chopin N, Malaret JM, Lafay-Pillet MC, et al. Total laparoscopic hysterectomy for benign uterine pathologies: obesity does not increase the risk of complications. Hum Reprod. 2009; 24(12): 3057–3062.
- Tohic ALe, Dhainaut C, Yazbeck C, et al. Hysterectomy for benign uterine pathology among women without previous vaginal delivery. Obstet Gynecol. 2008; 111(4): 829–837.
- David-Montefiore E, Rouzier R, Chapron C, et al. Collegiale d'Obstétrique et Gynécologie de Paris-Ile de France. Surgical routes and complications of hysterectomy for benign disorders: a prospective observational study in French university hospitals. Hum Reprod. 2007; 22(1): 260–265.
- Malinowski A, Makowska J, Antosiak B. Całkowite laparoskopowe usunięcie macicy - wskazania i powikłania u 158 pacjentek. Ginekol Pol. 2013; 84(4): 252–257.
- Dayaratna S, Goldberg J, Harrington C, et al. Hospital costs of total vaginal hysterectomy compared with other minimally invasive hysterectomy. Am J Obstet Gynecol. 2014; 210(2): 120.e1–120.e6.
- Pynnä K, Vuorela P, Lodenius L, et al. Cost-effectiveness of hysterectomy for benign gynecological conditions: a systematic review. Acta Obstet Gynecol Scand. 2014; 93(3): 225–232.
- Stadnicka G, Iwanowicz-Palus G, Mazurek A, et al. Poczucie satysfakcji z życia pacjentek po histerektomii. Ginekol Pol. 2012; 83: 347–352.
- Nieboer T, Johnson N, Lethaby A, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database of Systematic Reviews. 2009.
- Aarts JWM, Nieboer TE, Johnson N, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2015(8): CD003677.
- Warren L, Ladapo JA, Borah BJ, et al. Open abdominal versus laparoscopic and vaginal hysterectomy: analysis of a large United States payer measuring quality and cost of care. J Minim Invasive Gynecol. 2009; 16(5): 581–588.
- Wright KN, Jonsdottir GM, Jorgensen S, et al. Costs and outcomes of abdominal, vaginal, laparoscopic and robotic hysterectomies. JSLS. 2012; 16(4): 519–524.
- Goolab BD. Vaginal hysterectomy and relative merits over abdominal and laparoscopically assisted hysterectomy. Best Pract Res Clin Obstet Gynaecol. 2013; 27(3): 393–413.
- Sculpher M. Cost effectiveness analysis of laparoscopic hysterectomy compared with standard hysterectomy: results from a randomised trial. BMJ. 2004; 328(7432): 134–0.
- Augusto KL, Brilhante AV, Modesto GC, et al. Costs and mortality rates of surgical approaches to hysterectomy in Brazil. Rev Saude Publica. 2018; 52: 25.
- Boyd LR, Novetsky AP, Curtin JP. Effect of surgical volume on route of hysterectomy and short-term morbidity. Obstet Gynecol. 2010; 116(4): 909–915.
- Wright JD, Lewin SN, Deutsch I, et al. Effect of surgical volume on morbidity and mortality of abdominal hysterectomy for endometrial cancer. Obstet Gynecol. 2011; 117(5): 1051–1059.
- Rogo-Gupta LJ, Lewin SN, Kim JH, et al. The effect of surgeon volume on outcomes and resource use for vaginal hysterectomy. Obstet Gynecol. 2010; 116(6): 1341–1347.
