Yu Gu1, Lan Zhu2, Aimin Liu3, Jingran Ma4, Jinghe Lang1. 1. Department of Gynaecology and Obstetrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China. 2. Department of Gynaecology and Obstetrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China. Electronic address: zhu_julie@sina.com. 3. WHO Family of International Classifications Collaborating Centre, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China. 4. Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
Abstract
OBJECTIVE: To analyze surgical methods and medical costs for patients with uterine leiomyomas treated by hysterectomy in mainland China in 2010. METHODS: In a cross-sectional study, data for patients hospitalized with uterine leiomyomas and treated with hysterectomy were obtained from pooled medical records of 3030 hospitals. Type of surgery was categorized into abdominal hysterectomy (AH), laparoscopic hysterectomy (LH), and total vaginal hysterectomy (TVH). Length of stay and medical costs were analyzed for each procedure and in four types of hospital. RESULTS: Among 147 966 patients, 129 668 (87.6%) underwent AH, 9164 (6.2%) LH, and 9134 (6.2%) TVH. The total cost and operative cost were lowest for the AH group and highest for the LH group (P<0.001). Length of stay was shortest for TVH groups in all four types of hospital (P<0.001). The ratios between the frequencies of the three procedures were significantly different among the four types of hospital (P<0.001). CONCLUSION: In mainland China, AH remains the main surgical route of hysterectomy for patients with uterine leiomyomas. The length of stay was shortest among patients undergoing TVH, but the mean stay was still more than 9days.
OBJECTIVE: To analyze surgical methods and medical costs for patients with uterine leiomyomas treated by hysterectomy in mainland China in 2010. METHODS: In a cross-sectional study, data for patients hospitalized with uterine leiomyomas and treated with hysterectomy were obtained from pooled medical records of 3030 hospitals. Type of surgery was categorized into abdominal hysterectomy (AH), laparoscopic hysterectomy (LH), and total vaginal hysterectomy (TVH). Length of stay and medical costs were analyzed for each procedure and in four types of hospital. RESULTS: Among 147 966 patients, 129 668 (87.6%) underwent AH, 9164 (6.2%) LH, and 9134 (6.2%) TVH. The total cost and operative cost were lowest for the AH group and highest for the LH group (P<0.001). Length of stay was shortest for TVH groups in all four types of hospital (P<0.001). The ratios between the frequencies of the three procedures were significantly different among the four types of hospital (P<0.001). CONCLUSION: In mainland China, AH remains the main surgical route of hysterectomy for patients with uterine leiomyomas. The length of stay was shortest among patients undergoing TVH, but the mean stay was still more than 9days.