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Comparative Study
. 2012 Oct-Dec;16(4):519-24.
doi: 10.4293/108680812X13462882736736.

Costs and outcomes of abdominal, vaginal, laparoscopic and robotic hysterectomies

Kelly N Wright  1 , Gudrun M Jonsdottir, Selena Jorgensen, Neel Shah, Jon I Einarsson
Affiliations
Comparative Study

Costs and outcomes of abdominal, vaginal, laparoscopic and robotic hysterectomies

Kelly N Wright et al. JSLS. 2012 Oct-Dec.

Abstract

Background and objectives: To estimate the incidence of operative complications and compare operative cost and overall cost of different methods of benign hysterectomy including abdominal, vaginal, laparoscopic, and robotic techniques.

Methods: We performed a retrospective cohort analysis (Canadian Task Force classification II-2) of all patients who underwent a hysterectomy for benign reasons in 2009 at a single urban academic tertiary care center using the χ(2) test and Student t test. A multivariate regression analysis was also performed for predictors of costs. Cost data were gathered from the hospital's billing system; the remainder of data was extracted from patient's medical records.

Results: In 2009, 688 patients underwent a benign hysterectomy; 185 (26.9%) hysterectomies were abdominal, 135 (19.6%) vaginal, 352 (51.5%) laparoscopic, and 14 (2.0%) robotic. The rate of intraoperative complication was 1.7% for abdominal, 0.8% for vaginal, 0.3% for laparoscopic, and 0 for robotic. Mean total patient costs were $43,622 for abdominal, $31,934 for vaginal, $38,312 for laparoscopic, and $49,526 for robotic hysterectomies. Costs were significantly influenced by method of hysterectomy, operative time, and length of stay.

Conclusion: Though complication rates did not vary significantly among minimally invasive methods of hysterectomy, patient costs were significantly influenced by the method of hysterectomy.

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References

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