Clinical And Health Economics Evaluation Of Patients With Uterus Myoma Performing AH And LAVH

Objective:We undertook a retrospective research of medical records to carry out health economics evaluation of patients with uterine myoma performing AH and LAVH surgical procedures on basis of cost-effectiveness analysis and did follow-up evaluation of a wider range of benign gynecological diseases hysterectomy surgical experience of the selection to provide a theoretical basis for medical and health decision-making.Methods:We retrospectively analyzed 1205 cases of Obstetrics and Gynecology Hospital of Fudan University from 2004 to 2007(433 cases in LAVH group and 772 cases in AH group ) and compared their cost information and clinical indicators, including length of stay,operative time,blood loss,complication rate,suture removal, cure rate etc.and carried out cost-effectiveness analysis.Results:There were no statistically significant differences in the average age,proportion of surgical history and the uterine body diameter and the largest diameter of uterine myoma between LAVH group and AH group(47.1 vs 46.9, P＞0.05;36.5%vs 38.1%,P＞0.05;71.1mm vs 72.9mm,P＞0.05;48.8mm vs 50.2mm, P＞0.05).The length of stay,operative time,blood loss,complication rate,suture removal and time needed to recover normal diet in LAVH patients were significantly lower and better than that in AH patients(7.9d vs 10.5d,P＜0.01;96.8min vs 83.8min, P＜0.01;135.7ml vs 145.4ml,P＜0.05;3.7%vs 8.8%,P＜0.01;99.5%vs 98.3%, P＜0.05;3.37d vs 3.75d,P＜0.01).There were no statistically significant differences in cure rate,recharge rate and catheter pull-out time.The average cost in LAVH patients was significantly higher than that in AH patients(10994.81 vs 6589.54,P＜0.01). LAVH group compared with the AH group:we need to pay 1694.40 yuan to shorten the length of stay,to pay 1694.40 yuan to reduce the amount of bleeding,to pay 84.72 yuan to reduce one case of complications,to pay 13.43 yuan for each additional case of woundsⅡ/A healing and to pay 338.9 yuan for one minute operative time.Conclusion:LAVH group has the same cure rate with AH group and better clinical outcome,the latter has better cost-effectiveness ratio at present,but the former has a better furture.