Laparoscopic-assisted vaginal hysterectomy for endometrial cancer: clinical outcomes and hospital charges.
Laparoscopic-assisted vaginal hysterectomy for endometrial cancer: clinical outcomes and hospital charges.
复制标题
腹腔镜辅助阴道子宫切除术治疗子宫内膜癌：临床结果和医院费用。
DOI：
10.1006/gyno.1998.5311
复制
发表时间：
1999
影响因子：
4.7
通讯作者：
R. Barakat
中科院分区：
文献类型：
--
作者：
M. Gemignani;J. Curtin;J. Zelmanovich;D. A. Patel;E. Venkatraman;R. Barakat
目的
我们的目的是比较早期子宫内膜癌患者两种子宫切除术的临床结局和相关的住院费用。
方法
回顾性分析1991年7月1日至1996年9月30日在纪念斯隆-凯特琳癌症中心行腹腔镜辅助阴式子宫切除术（LAVH）或腹式子宫切除术（TAH）的320例早期子宫内膜癌患者的病历资料。
结果
69例患者（22%）接受LAVH治疗，251例（78%）接受TAH治疗。大多数患者（80%）患有I期疾病。两组的平均年龄相似：LAVH为60岁，TAH为61岁。LAVH组的平均体重为71 kg（范围43-117 kg），显著低于TAH组的82 kg（范围38-200 kg）（P < 0.05）。接受LAVH治疗的患者的总体并发症发生率较低。LAVH组手术时间（214 min）明显长于TAH组（144 min）（P < 0.05）。LAVH组的中位住院时间（2.0天）明显短于TAH组（6.0天）（P < 0.05）。TAH患者的住院费用（6960美元）明显高于LAVH患者（3130美元）（P < 0.05）。LAVH组的总体平均总费用（11，826美元）显著低于TAH组（15，189美元）（P < 0.05）。TAH组和LAVH组的中位随访时间分别为30个月和18个月，两者在疾病复发方面没有显著差异（P = 0.91）。
结论
与TAH治疗的患者相比，LAVH治疗早期子宫内膜癌的患者住院时间明显缩短，并发症较少，因此总体住院费用较低。长期结果相似。腹腔镜辅助阴式子宫切除术是一种有吸引力的选择，为选定的患者早期子宫内膜癌。
OBJECTIVE
Our objective was to compare the clinical outcomes and associated hospital charges between two methods of hysterectomy for patients with early-stage endometrial cancer.
METHODS
Retrospective chart review of 320 patients with early-stage endometrial cancer treated by laparoscopic-assisted vaginal hysterectomy (LAVH) or total abdominal hysterectomy (TAH) was performed for the period of July 1, 1991, to September 30, 1996, at Memorial Sloan-Kettering Cancer Center.
RESULTS
Sixty-nine patients (22%) were treated by LAVH, and 251 (78%) were treated by TAH. The majority of the patients (80%) had Stage I disease. The mean age was similar for both groups: 60 years for the LAVH vs 61 years for TAH. The mean weight was significantly lower for the LAVH group, 71 kg (range 43-117 kg), than for the TAH group, 82 kg (range 38-200 kg), (P < 0.05). Overall complication rates were lower among patients treated by LAVH. Operating room time was longer for the LAVH group (214 min) than for the TAH group (144 min) (P < 0.05). The median length of stay was significantly shorter for patients treated by LAVH (2.0 days) compared to TAH (6.0 days) (P < 0.05). Room charges were significantly higher for the TAH patients ($6960) compared to the LAVH patients ($3130) (P < 0.05). Overall mean total charges were significantly less for the LAVH group ($11,826) than for the TAH group ($15,189) (P < 0.05). With a median follow-up of 30 months for the TAH group and 18 months for the LAVH group, there was no significant difference in disease recurrence (P = 0.91).
CONCLUSION
Patients treated by LAVH for early-stage endometrial cancer had significantly shorter hospitalization and fewer complications, resulting in less overall hospital charges when compared to patients treated by TAH. Long-term outcome was similar. Laparoscopic-assisted vaginal hysterectomy is an attractive alternative for selected patients with early-stage endometrial cancer.
影响因子：
3.4
作者：
Warwick, Richard;Mediratta, Neeraj;Poullis, Michael
通讯作者：
Poullis, Michael