Laparoscopic-assisted vaginal hysterectomy for endometrial cancer: clinical outcomes and hospital charges.

Abstract

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.

0200400600'03'05'07'09'11'13'15'17
Citations per Year

3,058 Citations

Semantic Scholar estimates that this publication has 3,058 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Gemignani1999LaparoscopicassistedVH, title={Laparoscopic-assisted vaginal hysterectomy for endometrial cancer: clinical outcomes and hospital charges.}, author={Mary L. Gemignani and John P. Curtin and J Zelmanovich and Dr . Amit Patel and E. S. Venkatraman and Richard R. Barakat}, journal={Gynecologic oncology}, year={1999}, volume={73 1}, pages={5-11} }