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[Effect of different surgical approaches on quality of life and cost-consequence]
Jin-hua Leng1, Jing-he Lang, Hua-jun Li
1Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China.
Objective:
To evaluate the effects of total abdominal hysterectomy (TAH), laparoscopic hysterectomy (LH) and transvaginal hysterectomy (TVH) on quality of life, cost and health care utilization.
Methods:
A study of women who underwent elective hysterectomy was performed to assess the effect of operations on quality of life using WHO quality of life-bref before operation, at the 4th, 14th and 28th day after operation, respectively. The data of total cost and health care utilization were also analyzed.
Results:
The score of quality of life at the 4th day after operation in TVH patients was significantly higher than that in TAH patients (93 +/- 6 vs 81 +/- 11, P < 0.01). There was no significant difference in this score between TVH and LH, and between LH and TAH patients. However, at the 14th and 28th after operation, the scores in both TVH and LH patients were significantly higher than that in TAH patients (95 +/- 7 and 96 +/- 7 vs 85 +/- 9, P < 0.001 and 0.001; 96 +/- 10 and 98 +/- 7 vs 87 +/- 10, P < 0.01). There was no significant difference in the total costs among three groups. The better health care utilization was in LH and TVH patients, and the worse in TAH patients.
Conclusions:
The effect of LH and TVH on quality of life and health economics is similar, and appears to be superior than that of TAH.