Surgical outcome and cost comparison between total vaginal hysterectomy and laparoscopic hysterectomy for uteri weighing >500 g.
OBJECTIVE
To compare surgical outcomes and overall costs of less invasive methods of hysterectomy to treat benign disease including total vaginal hysterectomy (TVH) and total laparoscopic hysterectomy (TLH) in women with a uterus weighing >500 g.


METHODS
Retrospective review of medical records (Canadian Task Force classification III).


METHODS
University-associated hospital.


METHODS
One hundred three women with a uterus weighing >500 g who had undergone either total vaginal hysterectomy (TVH) (n = 52) or total laparoscopic hysterectomy (TLH) (n = 51).


RESULTS
Cost data were extracted from the hospital billing system. Patient characteristics, surgical outcomes, and hospital costs were compared between the 2 groups. Patient characteristics were similar in both groups except for a history of surgery (TVH 11.5%, and TLH 37.3%; p = .01). Insofar as surgical outcomes, mean (SD) operative time was shorter in the TVH group compared with the TLH group (110.00 [28.68] minutes vs 180.47 [51.32] minutes; p < .001), and hospital stay was longer (8.08 [0.68] days vs 7.45 [1.03] days; p < .001). Other surgical outcomes including estimated blood loss (p = .20) and decrease in hemoglobin (p = .12) did not differ between the 2 groups. Total hospital costs (converted from Korean won to US dollars) were significantly lower in the TVH group than in the TLH group ($2076.59 [$666.58] vs $2744.03 [$715.76]; p < .001).


CONCLUSIONS
Our data suggest that TVH is a safe and economic procedure even in women with a uterus weighing >500 g. Skilled surgeons should preferentially consider TVH for treatment of benign uterine disease, regardless of uterine size.
Department of Obstetrics and Gynecology, Hallym Universitiy, Dongtan Sacred Heart Hospital, Seoul, Korea.
Hye-Yon
HY
Cho
Department of Obstetrics and Gynecology, Hallym University, Kangnam Sacred Heart Hospital, Seoul, Korea.
Sung-Taek
ST
Park
Department of Obstetrics and Gynecology, Hallym University, Kangnam Sacred Heart Hospital, Seoul, Korea.
Hong-Bae
HB
Kim
Department of Obstetrics and Gynecology, Hallym University, Kangnam Sacred Heart Hospital, Seoul, Korea.
Sung-Won
SW
Kang
Department of Obstetrics and Gynecology, Hallym University, Kangnam Sacred Heart Hospital, Seoul, Korea. Electronic address: vth2000@naver.com.
Sung-Ho
SH
Park
D000328:Adult; D002170:Canada; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007044:Hysterectomy / Q000191:economics* / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000191:economics* / Q000379:methods; D007902:Length of Stay / Q000191:economics; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000191:economics* / Q000601:surgery; D014599:Uterus / Q000033:anatomy & histology* / Q000601:surgery
Costs; Laparoscopic hysterectomy; Large uterus; Vaginal hysterectomy