腹主动脉瘤开放修复术与血管腔内动脉瘤修复术的疗效及成本分析：日本单中心经验
The outcomes and cost analysis of open repair and endovascular aneurysm repair for abdominal aortic aneurysms: a single-center experience in Japan.
作者信息
Maze Yasumi, Tokui Toshiya, Inoue Ryotaro, Sekoguchi Tomotake, Narukawa Takahiro, Murakami Masahiko, Inoue Ryosai, Hirano Koji, Chino Shuji, Nakajima Ken, Kato Noriyuki, Ito Hisato
机构信息
Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie, 516-8512, Japan.
Department of Radiology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie, 516-8512, Japan.
出版信息
Surg Today. 2025 Apr;55(4):560-568. doi: 10.1007/s00595-024-02934-7. Epub 2024 Sep 4.
PURPOSE
Japan has adopted its own reimbursement system, which differs from other countries in terms of its diagnostic procedure combination (DPC) methods. However, there are few reports on the cost analysis of open repair and endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms in Japan. We aimed to evaluate the long-term outcomes and cost-effectiveness of these two procedures.
METHODS
This study included patients who underwent open repair (n = 224) and EVAR (n = 87) between January 2012 and December 2022. After propensity score matching, we compared the two groups.
RESULTS
The drug and blood products, procedures, and DPC costs were significantly higher in the open repair group (p < 0.001) than in the EVAR group. The surgical equipment and total costs were significantly higher in the EVAR group than in the open repair group (p < 0.001). There was no significant difference in the 5-year survival rate (88.5% in the open repair group vs. 72.0% in the EVAR group; p = 0.33) and freedom from re-intervention rate at 5 years (93.1% in the open repair group vs. 89.9% in the EVAR group; p = 0.15) between the two groups.
CONCLUSIONS
Open repair is more cost-effective than EVAR. The cost-effectiveness of EVAR may therefore depend on the cost of the endograft.
目的
日本采用了自己的报销系统，其诊断程序组合（DPC）方法与其他国家不同。然而，关于日本腹主动脉瘤开放修复术和血管内动脉瘤修复术（EVAR）的成本分析报告较少。我们旨在评估这两种手术的长期疗效和成本效益。
方法
本研究纳入了2012年1月至2022年12月期间接受开放修复术（n = 224）和EVAR（n = 87）的患者。在进行倾向评分匹配后，我们对两组进行了比较。
结果
开放修复组的药物和血液制品、手术及DPC成本显著高于EVAR组（p < 0.001）。EVAR组的手术设备和总成本显著高于开放修复组（p < 0.001）。两组的5年生存率（开放修复组为88.5%，EVAR组为72.0%；p = 0.33）和5年无再次干预率（开放修复组为93.1%，EVAR组为89.9%；p = 0.15）无显著差异。
结论
开放修复术比EVAR更具成本效益。因此，EVAR的成本效益可能取决于血管内移植物的成本。
Zotero 插件