The medical and economic impact of laparoscopically assisted vaginal hysterectomy in a large, metropolitan, not-for-profit hospital. Discussion.
The Central Association of Obstetricians and Gynecologists. Annual meeting. Memphis TN USA, 1994/10/13.
Our purpose was to evaluate the medical and economic impact of operative laparoscopy on the surgical approach to hysterectomy for benign disease in a large, metropolitan, not-for-profit hospital.
Retrospective analyses were performed on 2563 hysterectomies for benign disease, performed by 37 gynecologists between January 1991 and December 1993.
Disposable laparoscopic instruments and stapling devices were not used at any time during the study period.
Electrosurgery and sutures were used for hemostasis.
Parameters analyzed included surgical approach (total abdominal hysterectomy, vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy, and failed laparoscopically assisted vaginal hysterectomy), operative time, postoperative diagnosis, operative blood loss, length of stay, complications, uterine weight, and hospital charges.
Charges in each of these parameters were analyzed and compared in 6-month increments.
Contrary to previously published studies, our study demonstrates (1) laparoscopically assisted vaginal hysterectomy is a cost-effective procedure when performed with reusable instruments, (2) laparoscopically assisted vaginal hysterectomy is a safe procedure, even when performed by a variety of gynecologists with different skill levels, and (3) the number of hysterectomies performed abdominally was decreased by 29% without incurring more complications or reducing the number of vaginal cases.
Mots-clés Pascal : Hystérectomie, Chirurgie, Voie vaginale, Laparoscopie, Endoscopie, Appareil génital femelle pathologie, Utérus pathologie, Homme, Femelle, Economie santé, Pronostic, Complication, Etude longitudinale, Chirurgie endoscopique
Mots-clés Pascal anglais : Hysterectomy, Surgery, Vaginal route, Laparoscopy, Endoscopy, Female genital diseases, Uterine diseases, Human, Female, Health economy, Prognosis, Complication, Follow up study, Endoscopic surgery
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0411061
Code Inist : 002B25K. Création : 01/03/1996.