日本单中心经验：腹主动脉瘤开放修复与血管内修复的费用差异。
Cost disparity between open repair and endovascular aneurysm repair for abdominal aortic aneurysm: a single-institute experience in Japan.
机构信息
Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.
出版信息
Surg Today. 2012 Jan;42(2):121-6. doi: 10.1007/s00595-011-0041-4. Epub 2011 Nov 10.
PURPOSE
We conducted this study to compare the cost of open surgical repair (OR) with that of endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm (AAA).
METHODS
Between January 2007 and November 2008, 70 patients underwent open repair and 57 patients underwent EVAR. We evaluated the total cost, including that of the Diagnosis Procedure Combination (DPC), that of the surgical procedure, that of materials such as grafts and guide wires, and that of the anesthesia.
RESULTS
The mean costs for OR versus EVAR were as follows: DPC, ¥632,370 versus ¥490,050, respectively, which was significant; anesthesia, ¥123,540 versus ¥86,220, respectively (P < 0.05); and materials, ¥257,770 versus ¥2,113,280, respectively (P < 0.05). Thus, the mean total cost was ¥1,825,830 versus ¥3,159,270 for open repair and EVAR, respectively (P < 0.05).
CONCLUSIONS
New technologies should not only be clinically effective, but also cost effective. EVAR is less invasive clinically, but the cost of endovascular prostheses and other materials remains high.
目的
本研究旨在比较腹主动脉瘤（AAA）开放手术修复（OR）与血管内动脉瘤修复（EVAR）的成本。
方法
2007 年 1 月至 2008 年 11 月，70 例患者接受了开放修复，57 例患者接受了 EVAR。我们评估了总成本，包括诊断程序组合（DPC）、手术过程、移植物和导丝等材料以及麻醉的成本。
结果
OR 与 EVAR 的平均成本如下：DPC 分别为 632370 日元和 490050 日元，差异显著；麻醉分别为 123540 日元和 86220 日元（P < 0.05）；材料分别为 257770 日元和 2113280 日元（P < 0.05）。因此，OR 与 EVAR 的平均总成本分别为 1825830 日元和 3159270 日元（P < 0.05）。
结论
新技术不仅应具有临床疗效，还应具有成本效益。EVAR 在临床上具有较小的侵入性，但血管内假体和其他材料的成本仍然很高。
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