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机器人二尖瓣修复与传统二尖瓣修复的成本分析研究。

A cost-analysis study of robotic versus conventional mitral valve repair.

机构信息

Department of Surgery (Monash Medical Centre), Monash University, 246 Clayton Road, Clayton, VIC 3168, Australia.

出版信息

Heart Lung Circ. 2010 Jul;19(7):413-8. doi: 10.1016/j.hlc.2010.02.009. Epub 2010 Mar 30.

Abstract

BACKGROUND

Robotic mitral valve repair has been performed in Australia since 2004. The aim of this study was to perform a cost-analysis of robotic mitral valve repair (MVR) with direct comparison to conventional MVR surgery.

METHODS

All isolated MVRs performed within one metropolitan hospital network, between June 2005 and June 2008, were retrospectively compared. Ad hoc cost analysis was conducted.

RESULTS

There were 107 robotic and 40 conventional MVRs performed. The post-operative degrees of mitral regurgitation were comparable. Total operating time was 18% longer in robotic compared to conventional (239 min vs. 202 min, p<0.001, 95% CI: 11-27%). In robotic, Intensive Care Unit stay was reduced by 19% (p=0.002, 37 h vs. 45 h), and length of hospital stay was reduced by 26% (p<0.001, 6.47 days vs. 8.76 days). Mean hospital cost, without including capital costs, was not significantly increased (AUD$18,503 vs. AUD$17,880 p=0.176, 95% CI: -282 to 1,530).

CONCLUSIONS

Robotic mitral repair can be performed with similar immediate repair success rates as conventional surgery with a shorter recovery time, but a slightly longer operative time. There is no significant increase in cost over conventional surgery.

摘要

背景

自 2004 年以来,澳大利亚已经开展了机器人二尖瓣修复术。本研究旨在对机器人二尖瓣修复术(MVR)进行成本分析,并与传统的 MVR 手术进行直接比较。

方法

对 2005 年 6 月至 2008 年 6 月期间在一个都市医院网络内进行的所有孤立性 MVR 进行回顾性比较。进行了专门的成本分析。

结果

共进行了 107 例机器人二尖瓣修复术和 40 例传统二尖瓣修复术。术后二尖瓣反流程度相当。与传统手术相比,机器人手术的总手术时间长 18%(239 分钟比 202 分钟,p<0.001,95%可信区间:11-27%)。机器人手术中 ICU 停留时间减少了 19%(p=0.002,37 小时比 45 小时),住院时间减少了 26%(p<0.001,6.47 天比 8.76 天)。不包括资本成本在内的平均住院费用没有显著增加(18503 澳元比 17880 澳元,p=0.176,95%可信区间:-282 至 1530)。

结论

机器人二尖瓣修复术可以与传统手术具有相似的即时修复成功率,同时具有较短的恢复时间和稍长的手术时间。与传统手术相比,成本没有显著增加。

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