Clinical and financial analyses of laparoscopically assisted vaginal hysterectomy versus abdominal hysterectomy.
OBJECTIVE
To perform clinical and financial analyses of laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH).


METHODS
During the 16 months between August 1991 and December 1992, 34 women who underwent LAVH were compared with 60 women having TAH during 1990. Indications, surgical outcomes, complications, time to return to work, and hospital charges for each group were analyzed.


METHODS
A multispecialty group practice.


METHODS
The LAVH group included the first 34 cases by the senior author and were the only such procedures at this hospital. The TAH group included all patients having this procedure for benign conditions from the same group practice for 1990. Interventions. Either LAVH or TAH.


RESULTS
The most common primary indication in both groups was fibroids. Only one LAVH failed and was converted to a TAH. Postoperative complications were significantly greater for TAH than for LAVH (45% vs 9%). The length of stay and time to return to work were significantly less after LAVH. Total hospital charges increased for LAVH over TAH ($7623 vs $4550) despite a significantly shorter length of stay after LAVH.


CONCLUSIONS
Although LAVH has a significantly lower complication rate than TAH, it is more costly to perform. This higher cost, despite a shorter hospital stay, is attributed to high operating room charges. Employers and patients benefit from early return to work with LAVH.
Hidlebaugh
D
D
Fallon Fertility Center, 100 Central Street, Worcester, MA 01608, USA.
O'Mara
P
P
Conboy
E
E
D000041:Absenteeism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000503:physiopathology / Q000601:surgery; D017722:Hospital Charges; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000191:economics* / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000191:economics / Q000379:methods; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics* / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D007902:Length of Stay; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome