Myoga Mai, Sho Tomoko, Aoki Hitomi, Ishizuka Takaki, Nakajima Daisuke, Yoshimura Kazuaki
Department of Obstetrics and Gynecology, Wakamatsu Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan.
J Obstet Gynaecol Res. 2021 Apr;47(4):1567-1571. doi: 10.1111/jog.14683. Epub 2021 Jan 25.
To compare the perioperative costs analysis between laparoscopic/transvaginal and the mesh/non-mesh surgeries for pelvic organ prolapse (POP) in Japan.
From April 2013 to April 2017, 890 patients who underwent POP surgeries were enrolled in this study. Regarding transvaginal native tissue repair (TV-NTR: transvaginal hysterectomy with colpocleisis), transvaginal mesh surgery (TVM), laparoscopic native tissue repair (L-NTR: laparoscopic hysterectomy and uterosacral ligament colposuspension), and laparoscopic sacrocolpopexy (LSC), a retrospective observational study was performed. Patients' age, operation time, blood loss, perioperative complications, length of hospital stay, pre-/postoperative quality of life (QOL) scores, were reviewed from the medical records. The net income, which was calculated by using the income (the operation/anesthesia fee) and the costs (the labor and consumables costs for operation/anesthesia), was evaluated.
The operation fees of the L-NTR ($4250) and the LSC ($4833) groups were higher than that of the TV-NTR ($2652) and the TVM ($2913) groups. The labor costs and consumables costs of operation were higher in the LSC ($1589) and the L-NTR ($1500) groups than the TV-NTR ($180) and the TVM ($178) groups. The consumables costs for anesthesia in the four groups were equal. The operation hours were significantly shorter in the TV-NTR and the TVM groups than the L-NTR and the LSC groups.
We found that TVM operation was an economically excellent and the most efficient POP operation with shorter operation time and less consumables.
比较日本盆腔器官脱垂（POP）腹腔镜/经阴道手术与网片/非网片手术的围手术期成本分析。
2013年4月至2017年4月，890例行POP手术的患者纳入本研究。对经阴道自体组织修复术（TV-NTR：经阴道子宫切除术加阴道封闭术）、经阴道网片手术（TVM）、腹腔镜自体组织修复术（L-NTR：腹腔镜子宫切除术加子宫骶韧带阴道悬吊术）和腹腔镜骶骨阴道固定术（LSC）进行回顾性观察研究。从病历中查阅患者的年龄、手术时间、失血量、围手术期并发症、住院时间、术前/术后生活质量（QOL）评分。通过使用收入（手术/麻醉费用）和成本（手术/麻醉的人工和耗材成本）计算净收入并进行评估。
L-NTR组（4250美元）和LSC组（4833美元）的手术费用高于TV-NTR组（2652美元）和TVM组（2913美元）。LSC组（1589美元）和L-NTR组（1500美元）的手术人工成本和耗材成本高于TV-NTR组（180美元）和TVM组（178美元）。四组的麻醉耗材成本相等。TV-NTR组和TVM组的手术时间明显短于L-NTR组和LSC组。
我们发现TVM手术在经济上是优秀的，并且是最有效的POP手术，手术时间短且耗材少。
