Ann Ital Chir. 2020;91:49-54.
The cost effectiveness of the laparoscopic right hemicolectomy is still debated, and the current literature does not allow to be drawn certain conclusion. Our study compared direct clinical costs and outcomes for laparoscopic right hemicolectomy with the two most used type of anastomosis, such as ExtraCorporeal Anastomosis (ECA) and IntraCorporeal Anastomosis (ICA).
In this retrospective study, all patients who underwent laparoscopic right hemicolectomy with intracorporeal and extracorporeal anastomosis between January 2016 and April 2018 were evaluated. Patients were divided into two groups according to the type of anastomosis: ECA or ICA.
Thirty ECA and twenty-nine ICA patients were included in the study. Operative time was significantly longer in ICA group than ECA group (p < 0.001). No significant differences between the groups were seen in terms of timeto- first flatus, postoperative complications and re-admission rate. ICA group showed a shorter hospitalization (5 vs 6; p < 0.022). In the ICA group, considering only the surgical tools were more expensive than in ECA (1435.6 € vs 72 €). Nevertheless, the total cost of the two procedures in similar (14451.36 € in ECA group vs 14631.04 € in ICA group).
ECA and ICA are comparable in terms of postoperative outcomes. ICA requires much more expensive charges, compared to a minor hospitalization. The ECA seems to be less expensive in terms of surgical supplies but the longer recovery determines an increase in the total cost resulting in a non-inferiority of one compared to the other technique.
Cost-analysis, ExtraCorporeal Anastomosis, IntraCorporeal Anastomosis, Laparoscopy, Right Hemicolectomy.
腹腔镜右半结肠切除术的成本效益仍存在争议，目前的文献尚无法得出明确的结论。我们的研究比较了腹腔镜右半结肠切除术与两种最常用的吻合术（即体外吻合术[ECA]和体内吻合术[ICA]）的直接临床成本和结果。
在这项回顾性研究中，评估了 2016 年 1 月至 2018 年 4 月期间接受腹腔镜右半结肠切除术并进行体内和体外吻合的所有患者。根据吻合术的类型，患者分为 ECA 组和 ICA 组。
纳入研究的 ECA 组有 30 例，ICA 组有 29 例。ICA 组的手术时间明显长于 ECA 组（p < 0.001）。两组在首次排气时间、术后并发症和再入院率方面无显著差异。ICA 组的住院时间较短（5 天比 6 天；p < 0.022）。在 ICA 组中，仅考虑手术器械的费用就比 ECA 组高（1435.6 欧元比 72 欧元）。然而，两种手术的总费用相似（ECA 组为 14451.36 欧元，ICA 组为 14631.04 欧元）。
在术后结果方面，ECA 和 ICA 具有可比性。与较短的住院时间相比，ICA 需要更昂贵的费用。与手术耗材相比，ECA 的费用较低，但较长的恢复期导致总费用增加，使得两者在成本方面没有显著差异。
成本分析，体外吻合术，体内吻合术，腹腔镜，右半结肠切除术。
