title: Cost-effectiveness analysis of the treatment of large leiomyomas: laparoscopic assisted vaginal hysterectomy versus abdominal hysterectomy.
abstract: OBJECTIVE
  The purpose of this study was to perform a cost-effectiveness analysis comparing the treatment of large leiomyomas by laparoscopic assisted vaginal hysterectomy (LAVH) versus abdominal hysterectomy (AH).
  
  
  METHODS
  Twenty consecutive LAVH were compared to 20 consecutive AH for leiomyoma > or = 250 g. Hospital costs were obtained through Healthcare cost accounting system. The 6 principles of cost-effectiveness analysis were used.
  
  
  RESULTS
  The groups were similar in respect to age, weight, race, medical comorbidities, blood loss, and operative time. Median uterine weight (513 g) was approximately 20% > for LAVH. Length of stay and pain was significantly less for LAVH. Total hospital cost for AH was approximately 12% less expensive ($4394 vs $5023, P = .18).
  
  
  CONCLUSIONS
  Because of multiple benefits of LAVH versus AH and no significant difference in cost, we believe LAVH is an acceptable treatment for large leiomyoma.
authors.affiliation: Department of Obstetrics and Gynecology, Summa Health System, Northeastern Ohio Universities College of Medicine, Akron, OH 44309, USA.
authors.forename: Raja
authors.initials: R
authors.lastname: Mittapalli
authors.forename: James
authors.initials: J
authors.lastname: Fanning
authors.forename: Robert
authors.initials: R
authors.lastname: Flora
authors.forename: Bradford W
authors.initials: BW
authors.lastname: Fenton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000191:economics*; D007045:Hysterectomy, Vaginal / Q000191:economics; D010535:Laparoscopy / Q000191:economics; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000601:surgery*