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德国和英国基于 3D-与 2D 成像技术的腹腔镜手术的手术室时间节省:荟萃分析和预算影响模型-健康经济评估。

Operating room time savings in Germany- and UK-based hospitals with 3D- VS. 2D-imaging technology in laparoscopic surgery: Meta analysis and budget impact model - Health economic evaluation.

机构信息

Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine, University of Cologne, University Hospital Cologne, Germany.

Department of General and Visceral Surgery, Protestant Hospital of Bethel Foundation, University Hospital OWL, University of Bielefeld, Bielefeld, Germany.

出版信息

Int J Surg. 2022 Jun;102:106643. doi: 10.1016/j.ijsu.2022.106643. Epub 2022 Apr 29.

Abstract

AIMS

Opportunity cost (OC) analysis is key when evaluating surgical techniques. Operating room (OR) time is one potential source of OC in laparoscopic surgery. This study quantifies differences in OR time between 3D- and 2D-imaging technology in laparoscopic surgery, translates these into OC and models the economic impact in real-world hospitals.

METHODS

First a systematically performed literature review and meta-analysis were conducted. Then, methods to translate OR time savings into OC were theorised and a budget impact model was created. After that, the potential time savings of real-world hospital case mixes were extrapolated. Finally, the opportunity costs of not using 3D-imaging in laparoscopic surgery were evaluated.

RESULTS

Average OR time saving per laparoscopic procedure was -19.4 min (-24.3; -14.5) (-14%) in favour of 3D. The Budget Impact Model demonstrated an economic impact of using 3D-laparoscopy instead of 2D laparoscopy, ranging from £183,045-£866,316 in the British and 73,049€-437,829€ in German hospitals, modelling a mixture of cost savings and performing additional procedures (earning additional revenue).

CONCLUSION

The OC analysis revealed significant economic benefits of introducing 3D-imaging technology in laparoscopic surgery, on the basis that average procedure time is reduced. Utilising the saved OR time to perform additional procedures was the biggest driver of OC. Hospital case mix and procedure volume indicated the magnitude of the OC.

摘要

目的

机会成本(OC)分析是评估手术技术的关键。手术室(OR)时间是腹腔镜手术中潜在的 OC 来源之一。本研究量化了腹腔镜手术中 3D 和 2D 成像技术在 OR 时间方面的差异,将这些差异转化为 OC,并在实际医院中构建经济影响模型。

方法

首先进行了系统的文献回顾和荟萃分析。然后,理论上提出了将 OR 时间节省转化为 OC 的方法,并创建了预算影响模型。之后,推断了真实医院病例组合的潜在时间节省。最后,评估了在腹腔镜手术中不使用 3D 成像的机会成本。

结果

每例腹腔镜手术的平均 OR 时间节省为-19.4 分钟(-24.3;-14.5)(-14%),有利于 3D。预算影响模型表明,在英国医院,使用 3D 腹腔镜代替 2D 腹腔镜具有经济影响,范围从 183,045 英镑到 866,316 英镑不等,在德国医院为 73,049 欧元至 437,829 欧元不等,模型构建了成本节省和执行额外手术(获得额外收入)的混合情况。

结论

OC 分析表明,在腹腔镜手术中引入 3D 成像技术具有显著的经济效益,因为平均手术时间缩短。利用节省的 OR 时间来执行额外的手术是 OC 的最大驱动因素。医院病例组合和手术量表明 OC 的规模。

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