Costs and mortality rates of surgical approaches to hysterectomy in Brazil

Augusto, Kathiane Lustosa; Brilhante, Aline Veras Morais; Modesto, Gisele Cristine Duarte; Sabóia, Dayana Maia; Rocha, Cássia Fernandes Coelho; Karbage, Sara Arcanjo Lino; Magalhães, Thaís Fontes de; Bezerra, Leonardo Robson Pinheiro Sobreira

doi:10.11606/s1518-8787.2018052000129

Cited by 19 publications

(27 citation statements)

References 19 publications

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“…). Following assessment, 68 articles, involving 708 032 patients across 71 LMICs, were included in the review ( Tables S1 and S2 , supporting information). Country‐specific patient numbers were reported in 60 studies but were absent from six and two provided total LMIC patient numbers only.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of the use of big data to improve surgery in low- and middle-income countries

Knight

Ots

Maimbo

et al. 2019

British Journal of Surgery

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Background Technological advances have led to the generation of large amounts of data, both in surgical research and practice. Despite this, it is unclear how much originates in low‐ and middle‐income countries (LMICs) and what barriers exist to the use of such data in improving surgical care. The aim of this review was to capture the extent and impact of programmes that use large volumes of patient data on surgical care in LMICs. Methods A PRISMA‐compliant systematic literature review of PubMed, Embase and Google Scholar was performed in August 2018. Prospective studies collecting large volumes of patient‐level data within LMIC settings were included and evaluated qualitatively. Results A total of 68 studies were included from 71 LMICs, involving 708 032 patients. The number of patients in included studies varied widely (from 335 to 428 346), with 25 reporting data on 3000 or more LMIC patients. Patient inclusion in large‐data studies in LMICs has increased dramatically since 2015. Studies predominantly involved Brazil, China, India and Thailand, with low patient numbers from Africa and Latin America. Outcomes after surgery were commonly the focus (33 studies); very few large studies looked at access to surgical care or patient expenditure. The use of large data sets specifically to improve surgical outcomes in LMICs is currently limited. Conclusion Large volumes of data are becoming more common and provide a strong foundation for continuing investigation. Future studies should address questions more specific to surgery.

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Section: Resultsmentioning

confidence: 99%

“…Such projects require accurate national data, which do not exist in many regions. National registries can be expensive to establish and run, but are becoming more common in middle‐income countries, such as the Chinese Guangzhou Occupational Cohort and the Brazilian DATASUS registry.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Knight

Ots

Maimbo

et al. 2019

British Journal of Surgery

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“…It is associated with a greater financial outlay on laparoscopy equipment, although the length of stay in the ward and return to full efficiency is shorter in case of laparoscopy [13,14], which is consistent with the findings of Augusto KL et al, who conducted a cohort study in Brazil between 2010 and 2014. The costs of laparotomy are the highest, yet it is still the most frequently chosen method of removing the uterus [15]. Operator experience is, of course, an important aspect of the surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

“…The aim of the study was to perform a comparative analysis of hysterectomy costs versus the operative technique based on the data of 656 patients operated at the Department of Obstetrics and Gynecology with Gynecological Oncology Subdivision, Brothers Hospitallers of Saint John of God Hospital, Katowice, between 2016and 2018 (until May 31, 2018.…”

Section: Objectivesmentioning

confidence: 99%

“…

Material and methods:This retrospective research involved 656 patients who underwent hysterectomy for non-oncological reasons. The patients were subdivided into three groups, depending on the operative method (transabdominal, laparoscopic or transvaginal).

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Hysterectomy costs depending on operational technique

Kala¹,

Stojko

Sadłocha

2018

Ginekol Pol

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Objectives:The aim of the study was to perform a comparative analysis of hysterectomy costs versus the operative technique based on the data of 656 patients operated at the Department of Obstetrics and Gynecology with Gynecological Oncology Subdivision, Brothers Hospitallers of Saint John of God Hospital, Katowice, between 2016and 2018 (until May 31, 2018. Material and methods:This retrospective research involved 656 patients who underwent hysterectomy for non-oncological reasons. The patients were subdivided into three groups, depending on the operative method (transabdominal, laparoscopic or transvaginal). Next, treatment costs were compared, including the costs of hospitalization, operating block, operating block materials, drugs, anesthesia, and medical staff. The duration of the operation and the hospital stay were also analyzed as they significantly affected the final result.Results: Data analysis revealed that transvaginal hysterectomy generated the lowest costs. A positive relationship between low costs and the duration of surgery and hospitalization, which is significantly shortened in case of transvaginal hysterectomy, was confirmed. Conclusions:1. The transvaginal approach is the most cost-effective technique of hysterectomy. 2. Apart from the financial advantage, transvaginal hysterectomy is also associated with shorter hospitalization and faster recovery. 3. Emphasis should be placed on training physicians in minimally invasive hysterectomies -especially the transvaginal approach -so that the greatest percentage of patients who are deemed eligible for hysterectomy could be operated using this minimally invasive technique.

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Short‐term outcomes after an enhanced recovery after surgery protocol in abdominal hysterectomies for leiomyomas in a teaching hospital

Alvarenga‐Bezerra

Marques

Barbosa³

et al. 2022

Intl J Gynecology & Obste

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Objective: To compare the perioperative outcomes of patients undergoing abdominal hysterectomies for leiomyomas before and after the implementation of an enhanced recovery after surgery (ERAS) protocol in a teaching hospital.Methods: This prospective cohort study compared a patient group from a historical series (pre-ERAS) with another group after ERAS implementation. Fasting time, length of hospital stay, complications, readmission rates, and procedure-related hospital costs were analyzed.Results: Altogether, 187 patients were included in the analysis: 92 (49.2%) and 95 (50.8%) in the pre-ERAS and ERAS groups, respectively. Both groups had similar clinical characteristics. We observed reductions in surgical outcome findings: fasting time (13.9 to 6.7 h, P < 0.001), bladder catheter usage (21.1 to 10.9 h, P < 0.001), infection rates (20.7% to 5.3%, P = 0.002), length of stay (57.5 to 37.6 h), and 38.4% of the total estimated mean cost per procedure (USD $1570.8 to USD $967.2, P < 0.001) in the pre-ERAS and ERAS groups, respectively. Hospital readmission rates (P > 0.99) did not increase. Conclusion:ERAS protocol implementation for hysterectomies involving uterine leiomyomas reduced the length of hospital stay, surgical site infection rates, and hospital costs. A mean savings of USD $603.6 per procedure would allow 62.4% more hysterectomies to be performed.

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Costs and mortality rates of surgical approaches to hysterectomy in Brazil

Cited by 19 publications

References 19 publications

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Hysterectomy costs depending on operational technique

Short‐term outcomes after an enhanced recovery after surgery protocol in abdominal hysterectomies for leiomyomas in a teaching hospital

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