Costs and Outcomes of Abdominal, Vaginal, Laparoscopic and Robotic Hysterectomies
Costs and Outcomes of Abdominal, Vaginal, Laparoscopic and Robotic Hysterectomies
复制标题
DOI：
10.4293/108680812x13462882736736
复制
发表时间：
2012-10-01
影响因子：
1.5
通讯作者：
Einarsson, Jon I.
中科院分区：
文献类型：
--
作者：
Wright, Kelly N.;Jonsdottir, Gudrun M.;Einarsson, Jon I.
背景和目标：评估手术并发症的发生率，并比较不同良性子宫切除术方法（包括经腹、经阴道、腹腔镜和机器人技术）的手术成本和总成本。方法：我们进行了回顾性队列分析（加拿大工作组分类II-2）2009年在单一城市学术三级保健中心使用chi（2）t检验和Student t检验。还对成本的预测因素进行了多变量回归分析。从医院的计费系统收集的成本数据，其余的数据是从病人的医疗records.Results：在2009年，688例患者进行了良性子宫切除术; 185（26.9%）子宫切除术是腹部，135（19.6%）阴道，352（51.5%）腹腔镜，14（2.0%）机器人。术中并发症发生率为：腹部手术1.7%，阴道手术0.8%，腹腔镜手术0.3%，机器人手术0。平均总患者成本为腹部43，622美元，阴道31，934美元，腹腔镜38，312美元，机器人直肠切除术49，526美元。费用显着影响子宫切除术，手术时间和住院时间的方法。结论：虽然并发症发生率没有显着差异子宫切除术的微创方法，患者的费用显着影响子宫切除术的方法。
Background and Objectives: To estimate the incidence of operative complications and compare operative cost and overall cost of different methods of benign hysterectomy including abdominal, vaginal, laparoscopic, and robotic techniques.Methods: We performed a retrospective cohort analysis (Canadian Task Force classification II-2) of all patients who underwent a hysterectomy for benign reasons in 2009 at a single urban academic tertiary care center using the chi(2) test and Student t test. A multivariate regression analysis was also performed for predictors of costs. Cost data were gathered from the hospital's billing system; the remainder of data was extracted from patient's medical records.Results: In 2009, 688 patients underwent a benign hysterectomy; 185 (26.9%) hysterectomies were abdominal, 135 (19.6%) vaginal, 352 (51.5%) laparoscopic, and 14 (2.0%) robotic. The rate of intraoperative complication was 1.7% for abdominal, 0.8% for vaginal, 0.3% for laparoscopic, and 0 for robotic. Mean total patient costs were $43,622 for abdominal, $31,934 for vaginal, $38,312 for laparoscopic, and $49,526 for robotic hysterectomies. Costs were significantly influenced by method of hysterectomy, operative time, and length of stay.Conclusion: Though complication rates did not vary significantly among minimally invasive methods of hysterectomy, patient costs were significantly influenced by the method of hysterectomy.