Misa Perron-Burdick1, Amanda Calhoun2, Dennis Idowu2, Alice Pressman3, Eve Zaritsky2. 1. Department of General Internal Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California. Electronic address: Perron-BurdickM@obgyn.ucsf.edu. 2. Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, San Francisco, California. 3. Division of Research, Kaiser Permanente Northern California, San Francisco, California; Sutter Health Research, Development and Dissemination, San Francisco, California.
Abstract
STUDY OBJECTIVE: To compare length of hospital stay for minilaparotomy vs laparoscopic hysterectomy. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Kaiser Permanente Northern California, a large integrated health care delivery system. PATIENTS: Women >18 years of age undergoing laparoscopic or minilaparotomy hysterectomy because of benign indications from June 2009 through January 2010. INTERVENTION: Hysterectomy via minilaparotomy or laparoscopy. MEASUREMENTS AND MAIN RESULTS: Medical records were reviewed for outcomes of interest including length of stay and surgical and demographic data. Parametric and non-parametric analyses were used to compare the 2 groups. The study was powered to detect a difference of 8 hours in length of stay. Two hundred sixty-three cases were identified as hysterectomy via minilaparotomy (n = 100) or laparoscopy (n = 163). The laparoscopy group demonstrated a significantly shorter mean (SD) length of stay (19 [14] hours vs. 42 [20] hours; p < .001) and less blood loss (126 [140] mL vs. 241 [238] mL; p < .001). The minilaparotomy group experienced a shorter procedure time (113 [47] minutes vs. 197 [124] minutes; p < .001). There was no difference between the groups insofar as patient morbidity including intraoperative and postoperative complications, emergency visits, readmissions, or repeat operations. CONCLUSION: Compared with minilaparotomy, laparoscopic hysterectomy is associated with shorter length of hospital stay, longer operating time, and no increased patient morbidity. Published by Elsevier Inc.
STUDY OBJECTIVE: To compare length of hospital stay for minilaparotomy vs laparoscopic hysterectomy. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Kaiser Permanente Northern California, a large integrated health care delivery system. PATIENTS: Women >18 years of age undergoing laparoscopic or minilaparotomy hysterectomy because of benign indications from June 2009 through January 2010. INTERVENTION: Hysterectomy via minilaparotomy or laparoscopy. MEASUREMENTS AND MAIN RESULTS: Medical records were reviewed for outcomes of interest including length of stay and surgical and demographic data. Parametric and non-parametric analyses were used to compare the 2 groups. The study was powered to detect a difference of 8 hours in length of stay. Two hundred sixty-three cases were identified as hysterectomy via minilaparotomy (n = 100) or laparoscopy (n = 163). The laparoscopy group demonstrated a significantly shorter mean (SD) length of stay (19 [14] hours vs. 42 [20] hours; p < .001) and less blood loss (126 [140] mL vs. 241 [238] mL; p < .001). The minilaparotomy group experienced a shorter procedure time (113 [47] minutes vs. 197 [124] minutes; p < .001). There was no difference between the groups insofar as patient morbidity including intraoperative and postoperative complications, emergency visits, readmissions, or repeat operations. CONCLUSION: Compared with minilaparotomy, laparoscopic hysterectomy is associated with shorter length of hospital stay, longer operating time, and no increased patient morbidity. Published by Elsevier Inc.
Entities:
Keywords:
Hospital stay; Hysterectomy; Laparoscopy; Laparotomy; Length of stay; Minilaparotomy
Authors: Esteban Andryjowicz; Teresa B Wray; V Reinaldo Ruiz; James Rudolf; Sara Noroozkhani; Sandra Crowder; Jeff M Slezak Journal: Perm J Date: 2015-07-24