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              <text>&lt;a href="http://doi.org/10.1016/j.ajog.2006.12.029" target="_blank" rel="noreferrer noopener"&gt;http://doi.org/10.1016/j.ajog.2006.12.029&lt;/a&gt;</text>
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              <text>e19–21</text>
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                <text>Cost-effectiveness analysis of the treatment of large leiomyomas: laparoscopic assisted vaginal hysterectomy versus abdominal hysterectomy.</text>
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                <text>American Journal of Obstetrics &amp; Gynecology</text>
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                <text>Adult; Female; Aged; Hysterectomy; Costs and Cost Analysis; Human; Middle Age; Cost Benefit Analysis; Visual Analog Scaling; Health Facility Costs; 80 and Over; Leiomyoma – Surgery; Hysterectomy – Economics; Laparoscopy – Economics; Uterine Neoplasms – Surgery; Vaginal – Economics</text>
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                <text>Mittapalli R; Fanning J; Flora R; Fenton BW</text>
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                <text>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). STUDY DESIGN: Twenty consecutive LAVH were compared to 20 consecutive AH for leiomyoma \textgreater 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% \textgreater 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). CONCLUSION: Because of multiple benefits of LAVH versus AH and no significant difference in cost, we believe LAVH is an acceptable treatment for large leiomyoma.</text>
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                <text>&lt;a href="http://doi.org/10.1016/j.ajog.2006.12.029" target="_blank" rel="noreferrer noopener"&gt;10.1016/j.ajog.2006.12.029&lt;/a&gt;</text>
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