Choi Yoo Shin, Lee Sang-Il, Lee Taek-Gu, Kim Sung-Wook, Cheon Guineum, Kang Sung-Bum
Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
Surg Today. 2007;37(2):127-32. doi: 10.1007/s00595-006-3356-9. Epub 2007 Jan 25.
To compare the economic outcomes of laparoscopic surgery (LAP) with those of open surgery (OS) for colorectal cancer.
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.
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.
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.
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。
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。
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。
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。