BMJ  2004;328 (17 January), doi:10.1136/bmj.328.7432.0

Laparoscopic hysterectomy: less pain, more complications, similar costs

Laparoscopic hysterectomy carries a shorter in hospital stay and results in less pain six weeks after the operation, but it has more major complications than abdominal hysterectomy. Analysing data from the eVALuate study, a large multicentre trial involving 1346 women, Garry and colleagues (p 129) found a higher rate of major complications and longer operative time in the laparoscopic group than with the conventional abdominal approach. At six weeks patients who had laparoscopy had less pain and better quality of life.

The cost effectiveness of the laparoscopic methods are similar to conventional vaginal and abdominal hysterectomy. Sculpher and colleagues (p 134) compared data from the eVALuate trial and found that the laparoscopic method increases costs and has a small effect on quality adjusted life years after a year. Laparoscopic vaginal hysterectomy was not cost effective, and when the abdominal approach was used, costs of laparoscopy were close to the limit of £30 000 per QALY the NHS is willing to pay.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Cost effectiveness analysis of laparoscopic hysterectomy compared with standard hysterectomy: results from a randomised trial

Mark Sculpher, Andrea Manca, Jason Abbott, Jayne Fountain, Su Mason, and Ray Garry
BMJ 2004 328: 134. [Abstract] [Full Text] [PDF]

The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy

Ray Garry, Jayne Fountain, Su Mason, Jeremy Hawe, Vicky Napp, Jason Abbott, Richard Clayton, Graham Phillips, Mark Whittaker, Richard Lilford, Stephen Bridgman, and Julia Brown
BMJ 2004 328: 129. [Abstract] [Full Text] [PDF]

Online poll

Find out more >>