Division of Pediatric Surgery, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, CA 90027, USA.
J Pediatr Surg. 2010 Apr;45(4):793-5. doi: 10.1016/j.jpedsurg.2009.06.021.
Transinguinal laparoscopy offers a safe and effective method for evaluating the contralateral groin during unilateral inguinal hernia repair (UIHR). The purpose of this study is to determine whether laparoscopic contralateral groin exploration (LCGE) is cost effective.
A retrospective review of all children who underwent UIHR and LCGE from 2006 to 2007 by a single surgeon was performed. Cost analysis comparing the time to perform the LCGE and time to repair the contralateral patent processus vaginalis (CPPV) to the cost saved by preventing future operation for a contralateral inguinal hernia repair was calculated based on Medicare reimbursement.
Eighty-one patients underwent UIHR with planned LCGE; 78 (96.3%) had successful LCGE; 8 (10.3%) had a CPPV and underwent contralateral open repair. The total cost for the additional time to perform LCGE and repair of the 8 CPPV was $13,080. The total cost for returning for a second operation to repair the contralateral inguinal hernia was $20,440.
Laparoscopic contralateral groin exploration at the time of unilateral inguinal hernia repair was cost effective.
经腹腹腔镜检查为单侧腹股沟疝修补术（UIHR）期间评估对侧腹股沟提供了一种安全有效的方法。本研究的目的是确定腹腔镜对侧腹股沟探查（LCGE）是否具有成本效益。
对 2006 年至 2007 年间由一位外科医生进行的所有接受 UIHR 和 LCGE 的儿童进行了回顾性研究。根据医疗保险报销情况，对进行 LCGE 的时间和修复对侧未闭鞘突（CPPV）的时间与避免未来对侧腹股沟疝修补术的成本节省进行了成本分析。
81 例患者接受了 UIHR 并计划进行 LCGE；78 例（96.3%）成功进行了 LCGE；8 例（10.3%）有 CPPV 并接受了对侧开放修复。进行额外的 LCGE 和修复 8 例 CPPV 的总时间成本为 13080 美元。因对侧腹股沟疝而返回进行第二次手术的总成本为 20440 美元。
在单侧腹股沟疝修补术时进行腹腔镜对侧腹股沟探查具有成本效益。
