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韩国腹腔镜手术与开腹手术治疗结直肠癌的经济结果

Economic outcomes of laparoscopic versus open surgery for colorectal cancer in Korea.

作者信息

Choi Yoo Shin, Lee Sang-Il, Lee Taek-Gu, Kim Sung-Wook, Cheon Guineum, Kang Sung-Bum

机构信息

Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Seongnam-si, Gyeonggi-do, 463-707, South Korea.

出版信息

Surg Today. 2007;37(2):127-32. doi: 10.1007/s00595-006-3356-9. Epub 2007 Jan 25.

Abstract

PURPOSE

To compare the economic outcomes of laparoscopic surgery (LAP) with those of open surgery (OS) for colorectal cancer.

METHODS

We compared operating room (OR) costs, OR hospital-profits, total hospital charges, and payments made for 67 consecutive patients who underwent either OS (n = 41) or LAP (n = 26) for colorectal cancer.

RESULTS

The operating time was longer in the LAP group (P < 0.001), but the hospital stay was shorter (P < 0.001). OR costs were higher in the LAP group, which was primarily attributed to the higher costs of consumables (LAP 1441, OS 575 dollars; P < 0.001) and the longer operating time (LAP 215 min, OS 155 min; P < 0.001). Total hospital charges were also higher after LAP (LAP 5017 dollars, OS 4093 dollars; P < 0.001). Patients paid more after LAP (P < 0.001), but there was no significant difference between the two groups in National Health Insurance Corporation payments.

CONCLUSION

Laparoscopic surgery is less cost-effective than OS for colorectal cancer. The higher costs of consumables and the longer operating time associated with LAP must be addressed to make LAP more cost-effective.

摘要

目的

比较腹腔镜手术(LAP)与开放手术(OS)治疗结直肠癌的经济结果。

方法

我们比较了连续67例接受OS(n = 41)或LAP(n = 26)治疗结直肠癌患者的手术室(OR)成本、OR医院利润、总医院费用以及支付费用。

结果

LAP组手术时间更长(P < 0.001),但住院时间更短(P < 0.001)。LAP组的OR成本更高,这主要归因于耗材成本更高(LAP 1441美元,OS 575美元;P < 0.001)以及手术时间更长(LAP 215分钟,OS 155分钟;P < 0.001)。LAP术后总医院费用也更高(LAP 5017美元,OS 4093美元;P < 0.001)。LAP后患者支付更多(P < 0.001),但两组在国民健康保险机构支付方面无显著差异。

结论

对于结直肠癌,腹腔镜手术的成本效益低于OS。必须解决与LAP相关的更高耗材成本和更长手术时间问题,以使LAP更具成本效益。

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