Cost-effectiveness analysis of the treatment of large leiomyomas: laparoscopic assisted vaginal hysterectomy versus abdominal hysterectomy.

Cost-effectiveness analysis of the treatment of large leiomyomas: laparoscopic assisted vaginal hysterectomy versus abdominal hysterectomy.

Mittapalli Raja; Fanning James; Flora Robert; Fenton Bradford W

American journal of obstetrics and gynecology

2007

2007-05

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.

80 and over; Adult; Aged; Cost-Benefit Analysis; Female; Humans; Hysterectomy; Hysterectomy/*economics; Laparoscopy/economics; Leiomyoma/*surgery; Middle Aged; Uterine Neoplasms/*surgery; Vaginal/economics

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