Department of Surgery, Central Hospital, Västerås, Sweden.
Br J Surg. 2010 May;97(5):765-71. doi: 10.1002/bjs.6945.
Laparoscopic surgery has emerged as a new treatment modality for inguinal hernia repair. The aim of the present study was to analyse its long-term costs in relation to those of open repair.
A randomized multicentre study comparing totally extraperitoneal laparoscopic repair (TEP) with open repair by the Lichtenstein procedure was performed on men with a primary inguinal hernia. Long-term data on recurrences and complications up to 5 years after operation were collected. Taking treatment costs into consideration, a cost-minimization analysis was conducted.
A total of 1370 patients had an inguinal hernia repair, 665 in the TEP and 705 in the Lichtenstein group. The total hospital cost for the index operation was 710.6 euro higher for TEP repair (P < 0.001). Including costs associated with recurrences and complications, this difference increased to 795.1 euro (P < 0.001). Taking community costs into account, the difference decreased by 503.1 euro to 292.0 euro (P = 0.024).
This cost-minimization analysis, including complications, reoperations and community costs during follow-up of 5 years, showed that laparoscopic inguinal hernia repair had a small but significant increase in overall costs compared with open repair.
腹腔镜手术已成为治疗腹股沟疝的一种新方法。本研究旨在分析其与开放式修复相关的长期成本。
对男性原发性腹股沟疝患者进行了一项随机多中心研究，比较了完全腹膜外腹腔镜修补术（TEP）与经Lichtenstein 手术的开放式修补术。收集术后 5 年内复发和并发症的长期数据。考虑治疗成本，进行了成本最小化分析。
共有 1370 例患者接受了腹股沟疝修补术，TEP 组 665 例，Lichtenstein 组 705 例。TEP 修复的总住院费用比 Lichtenstein 组高出 710.6 欧元（P<0.001）。包括与复发和并发症相关的费用在内，这一差异增加到 795.1 欧元（P<0.001）。考虑社区成本后，这一差异减少了 503.1 欧元，降至 292.0 欧元（P=0.024）。
这项成本最小化分析，包括并发症、再次手术和 5 年随访期间的社区成本，表明与开放式修复相比，腹腔镜腹股沟疝修补术的总费用略有增加，但具有统计学意义。
