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

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