Laparoscopic supracervical hysterectomy versus laparoscopic-assisted vaginal hysterectomy.
OBJECTIVE
To compare the incidence of perioperative complications and postoperative healthcare utilization and costs in laparoscopic supracervical hysterectomy (LSH) versus laparoscopic-assisted vaginal hysterectomy (LAVH) patients.


METHODS
Women 18 years with LSH or LAVH were extracted using a large national commercial claims database from 1/1/2007 through 9/30/2008. Outcome was perioperative complications and gynecologic-related postoperative resource use and costs. Multivariate analysis was performed to compare postsurgical outcomes between the cohorts.


RESULTS
The final sample consisted of 6,198 LSH patients and 14,181 LAVH patients. LSH patients were significantly more likely to have dysfunctional uterine bleeding and leiomyomas and less likely to have endometriosis and prolapse as the primary diagnosis, and also significantly more likely to have a uterus that weighed 250 grams than LAVH patients. Compared with LAVH patients, LSH patients had significantly lower overall infection rates (7.4% versus 6.2%, P .002) and lower total gynecologic related postoperative costs ($252 versus $385, P .001, within 30 days of follow-up and $350 versus $569, P .001, within 180 days of follow-up). Significant cost differences remained following multivariate adjustment for patient characteristics.


CONCLUSIONS
LSH patients demonstrated fewer perioperative complications and lower GYN-related postoperative costs compared to LAVH patients.
Thomson Reuters, Cambridge, MA, USA. xue.song@thomsonreuters.com
Xue
X
Song
Heidi C
HC
Waters
Katy
K
Pan
Dhinagar
D
Subramanian
Robert C
RC
Sedgley
Gregory J
GJ
Raff
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000191:economics / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000191:economics / Q000379:methods; D015994:Incidence; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology