Earle D, Seymour N, Fellinger E, Perez A
Department of Surgery, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, USA.
Surg Endosc. 2006 Jan;20(1):71-5. doi: 10.1007/s00464-005-0091-z. Epub 2005 Dec 7.
To analyze hospital resource utilization for laparoscopic vs open incisional hernia repair including the postoperative period.
Prospectively collected administrative data for incisional hernia repairs were examined. A total of 884 incisional hernia repairs were examined for trends in type of approach over time. Starting October 2001, detailed records were available, and examined for operating room (OR) time, cost data, length of stay (LOS), and 30-day postoperative hospital encounters.
Of the total, 469 incisional hernias were approached laparoscopically (53%) and 415 open (47%). Laparoscopic repair had shorter LOS (1 +/- 0.2 days vs 2 +/- 0.6 days), longer OR time (149 +/- 4 min vs 89 +/- 4 min), higher supply costs (2,237 dollars +/- 71 dollars vs 664 dollars +/- 113 dollars), slightly lower total hospital cost (6,396 dollars +/- 477 dollars vs 7,197 dollars +/- 1,819 dollars), and slightly more postoperative hospital encounters (15% vs 13%). Use of laparoscopy increased over time (37% in 2000 vs 68% in 2004).
Laparoscopic incisional hernia repair is becoming increasingly popular, and not at increased cost to the health care system.
分析腹腔镜与开放手术修补切口疝的医院资源利用情况,包括术后阶段。
对前瞻性收集的切口疝修补手术管理数据进行检查。共检查了884例切口疝修补手术,以观察手术方式随时间的变化趋势。从2001年10月起可获得详细记录,并对手术室(OR)时间、成本数据、住院时间(LOS)和术后30天内的医院诊疗情况进行检查。
总计469例切口疝采用腹腔镜手术(53%),415例采用开放手术(47%)。腹腔镜修补的住院时间较短(1±0.2天对2±0.6天),手术室时间较长(149±4分钟对89±4分钟),耗材成本较高(2237美元±71美元对664美元±113美元),总住院成本略低(6396美元±477美元对7197美元±1819美元),术后医院诊疗次数略多(15%对13%)。随着时间推移,腹腔镜手术的使用增加(2000年为37%,2004年为68%)。
腹腔镜切口疝修补术越来越受欢迎,且不会增加医疗系统的成本。