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

Year 2018, Volume: 49 Issue: 1, 24 - 27, 05.03.2018

Cetin Kilicci , Evrim Bostancı , Mesut Polat , Aysen Boza Cigdem Yayla Abide

https://doi.org/10.16948/zktipb.370500

Cited By: 1

Abstract

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.

Keywords

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

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