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A randomized trial with a cost-consequence analysis after laparoscopic and abdominal hysterectomy
M Ellström1, J Ferraz-Nunes, M Hahlin
1Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, and the Gothenburg University School of Public Administration, Göteberg, Sweden.
Obstetrics and Gynecology
|February 17, 1998
Summary
Total laparoscopic hysterectomy (TLH) offers faster recovery and significant cost savings compared to total abdominal hysterectomy (TAH). This surgical approach benefits patient health status and provides substantial financial advantages.
Area of Science:
- Gynecology
- Surgical Innovation
- Health Economics
Background:
- Hysterectomy is a common surgical procedure.
- Traditional total abdominal hysterectomy (TAH) involves a longer recovery period.
- Minimally invasive techniques like total laparoscopic hysterectomy (TLH) are increasingly adopted.
Purpose of the Study:
- To conduct a cost-consequence analysis comparing TLH and TAH.
- To evaluate the impact of surgical approach on patient health status and economic outcomes.
Main Methods:
- Prospective randomized trial comparing TLH (n=71) and TAH (n=72).
- Postoperative health status assessed using the SF-36 questionnaire.
- Economic analysis included direct hospital costs and indirect costs (lost productivity).
Main Results:
- Patients undergoing TLH experienced significantly faster improvement in postoperative health status.
- Direct costs were marginally higher for TLH (1.7%), but indirect costs were substantially lower (50.3%).
- Overall total costs were 23.1% lower for TLH compared to TAH.
Conclusions:
- TLH is a viable alternative to TAH, maintaining patient health status.
- Switching to TLH yields significant financial benefits for society.
- Laparoscopic surgery offers a cost-effective and clinically effective approach to hysterectomy.