Hui Yik Jing, Teo Alex Quok An, Sharma Siddharth, Tan Bryan Hsi Ming, Kumar V Prem
1 University Orthopaedics, Hand & Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
2 Yong Loo Lin School of Medicine, National University of Singapore.
J Orthop Surg (Hong Kong). 2017 Jan;25(1):2309499016684496. doi: 10.1177/2309499016684496.
While there has been increasing interest in minimally invasive surgery, the expenses incurred by patients undergoing this form of surgery have not been comprehensively studied. The authors compared the costs borne by patients undergoing arthroscopic rotator cuff repair with the standard mini-open repair at a tertiary hospital in an Asian population.
This was a retrospective cohort study. The authors studied the inpatient hospital bills of patients following rotator cuff tear repair between January 2010 and October 2014 via the hospital electronic medical records system. 148 patients had arthroscopic repair and 78 had mini-open repair. The cost of implants, consumables, and the total cost of hospitalization were analyzed. Operative times and length of stay for both procedures were also studied. Constant scores and American Shoulder Elbow Scores (ASES) were recorded preoperatively and at 1 year postoperatively.
Three fellowship-trained surgeons performed arthroscopic repairs and one performed the mini-open repair. The cost of implants and consumables was significantly higher with arthroscopic repair. The duration of surgery was also significantly longer with that technique. There was no difference in length of stay between the two techniques. There was also no difference in Constant scores or ASES scores, both preoperatively and at 1 year postoperatively.
The immediate costs of mini-open repair of rotator cuff tears are significantly less than that of arthroscopic repair. Most of the difference arises from the cost of implants and consumables. Equivalent functional outcomes from both techniques suggest that mini-open repair may be more cost-effective.
尽管人们对微创手术的兴趣日益浓厚,但对于接受这种手术方式的患者所产生的费用尚未进行全面研究。作者比较了在一家亚洲三级医院接受关节镜下肩袖修补术与标准小切口开放修补术的患者所承担的费用。
这是一项回顾性队列研究。作者通过医院电子病历系统研究了2010年1月至2014年10月肩袖撕裂修补术后患者的住院账单。148例患者接受了关节镜修补术,78例接受了小切口开放修补术。分析了植入物、耗材的费用以及住院总费用。还研究了两种手术的手术时间和住院时间。记录术前及术后1年的Constant评分和美国肩肘评分(ASES)。
三名经过专科培训的外科医生进行关节镜修补术,一名进行小切口开放修补术。关节镜修补术的植入物和耗材费用显著更高。该技术的手术时间也显著更长。两种技术的住院时间没有差异。术前及术后1年的Constant评分或ASES评分也没有差异。
肩袖撕裂小切口开放修补术的直接费用显著低于关节镜修补术。大部分差异来自植入物和耗材的费用。两种技术的功能结果相当,这表明小切口开放修补术可能更具成本效益。