Laparoscopy Versus Laparotomy For Surgical Treatment of Obese Women With Endometrial Cancer : a Cost-Benefit Comparative Analysis
Bibliographic record
Abstract
PurposeTo demonstrate the cost of obese patients affected by endometrial cancer undergoing open surgery compared to minimally invasive surgery.MethodsRetrospective cohort study (Canadian Task Force classification II-2). Economic expenditure in pre-operative, intra-operative and post-operative phases of the selected patients was evaluated. Costs were analyzed for all blood tests, instrumental examinations, consultations, operating materials, drugs, gynecological examinations, hospital stay, intensive care hospitalization and management of operative complications.ResultsThe average length of stay was longer for patients operated by laparotomy with an almost double median hospitalization cost in the open abdominal group compared to the laparoscopic group (u20ac 4805.37 vs. u20ac 2589.25; p <0.0001). Evaluation by another specialist (cardiologist, diabetologist, internist) was necessary in 30.9% of laparotomies versus 10.4% of laparoscopies (p = 0.003). Respiratory support was applied to 38 patients (28.8%), of whom 23 (41.8%) were in the open abdominal arm (p = 0.011). Antibiotic and pain-relief therapies resulted in a significantly higher cost for the open abdominal than for the minimally-invasive approach (p = 0.027). Considering all the pre-, intra- and post-operative course, the expenses for an obese patient operated by laparoscopy was u20ac 4412.41 vs. u20ac 7323.17 by open surgery, with an average saving of u20ac 2911.03 in favor of minimally-invasive surgery. ConclusionThis study shows that in obese patients with endometrial cancer, minimally invasive surgery is more advantageous both in terms of costs and post-operative complications. Laparoscopic surgery in obese patients allows an economic saving of about 60% less than open surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.004 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".