Abdominal, vajinal ve total laparoskopik histerektominin maliyet etkinliklerinin ve klinik sonuçlarının seçili hasta grubunda karşılaştırılması

Öz

Amaç: Total laparoskopik histerektomi (TLH), total abdominal histerektomi (TAH) ve vajinal histerektominin (VH) perioperatif ve postoperatif sonuçlarını; seçili hasta grubunda karşılaştırmaktır.

Gereç ve Yöntem: 223 histerektomi çalışmaya dahil edildi. Hastalar üç gruba ayrıldı. Grup 1'de TLH (n = 63); Grup 2'de TAH (n = 133), Grup 3 ise VH (n = 37) yapılan hastalardan oluşuyordu. Her üç grubun da benzer yaş, parite ve uterus boyutları vardı. Başlıca değerlendirilen ölçütler; ameliyat süresi, ateş, analjezi gereksinimi, hastanede kalış süresi, işe geri dönüş süresi, perioperatif ve postoperatif komplikasyonlar, kan transfüzyonu sayısı ve ameliyat masrafları idi.

Bulgular: Operasyon süresi VH grubunda en kısa idi. Üç grup arasında hastanede kalış süreleri açısından anlamlı farklılık saptanmadı. VH en ucuz histerektomi tipiydi. VH grubu TLH grubuyla karşılaştırıldığında; analjezik gereksinimi ve işe geri dönüş süresi açısından istatistiki fark tespit edilmedi. VH grubunda; TAH (p = 0.001) ve TLH gruplarına kıyasla daha fazla kan transfüzyonu gerektiği saptandı(p <0.001).

Sonuç: VH diğer iki teknik ile karşılaştırıldığında en kısa operasyon süresi ve en düşük cerrahi maliyete sahipken; benzer perioperatif ve postoperatif sonuçlar saptandı.

Anahtar Kelimeler

• laparoskopik histerektomi,abdominal histerektomi,vajinal histerektomi,maliyet etkinlik

Comparison of cost-effectivenes and clinical outcomes of abdominal, vaginal and total laparoscopic hysterectomy in a selected group

Abstract

Objective: The aim was to compare the perioperative and postoperative outcomes of total laparoscopic hysterectomy(TLH), total abdominal hysterectomy(TAH), and vaginal hysterectomy(VH) in a selected group of patients.

Materials and Methods: Two hundred twenty-three hysterectomies were included in this study. The patients were separated into three groups. Group1 included patients with TLH(n=63); TAH patients were placed in Group 2(n=133), and Group 3 was made up of patients who underwent VH(n=37). All three groups had similar ages, parities, and uterine sizes. The main outcome measures were operation time, fever, need for analgesia, duration of hospital survellience, return to work time, perioperative and postoperative complications, the number of blood transfusions, and costs of the surgery.

Results: The total operation time was the shortest in the VH group. There was no significant difference in the hospital survellience duration between the three groups. The VH was found to be the cheapest type of hysterectomy. When the VH group was compared with the TLH group, there was no difference in the use of analgesics for postoperative pain or the time return to work. The VH group patients required more blood transfusions in contrast with the TAH(p=0.001) and TLH groups(p<0.001).

Conclusion: VH had similar operative and postoperative outcomes but the shortest duration of operation and the lowest surgical cost compared with the other two techniques.

Keywords

• total laparoscopic hysterectomy,total abdominal hysterectomy,vaginal hysterectomy,cost-effectiveness

Kaynakça

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