印度环境下腹腔镜腹膜内补片修补术治疗腹疝的成本效益分析综述。
Review for cost-effectiveness analysis of laparoscopic Intra-peritoneal Onlay Mesh for ventral hernia repair in Indian settings.
作者信息
Guleria Charu, Kumar Dinesh, Sahoo Krushna Chandra
机构信息
Dr. Rajendra Prasad Government Medical College, Kāngra, India.
Department of Health Research, New Delhi, India.
出版信息
Cost Eff Resour Alloc. 2025 Jun 10;23(1):27. doi: 10.1186/s12962-025-00638-4.
BACKGROUND
Health Technology Assessment in India (HTAIn) carries evidence-based decision making in improving health care. This study was done to assess cost-effectiveness of the laparoscopic IPOM technique compared to open VHR from health system perspective of India.
METHODS
A Meta-analysis of outcomes of both procedures was carried out whereas cost estimates were obtained from national health system costing database.
RESULTS
A meta-analysis of Randomized Control Trials (RCTs) showed similar risk in hernia recurrence rates between laparoscopic IPOM and open technique (RR: 1.28 95% C.I: 0.81, 2.04) but with significantly less risk for wound infections (RR: 0.31 95% C.I: 0.18, 0.54). Estimated cost from National Health System Costing Database (NHSCD) per VHR was high for laparoscopic IPOM (INR 58,872) compared to open hernioplasty (INR 36,166) with estimated Incremental Cost-Effective Ratio of INR 5,023 per wound infection averted.
CONCLUSIONS
Laparoscopic IPOM was not clinically effective in hernia recurrence and less likely to be cost-effective.
背景
印度卫生技术评估（HTAIn）在改善医疗保健方面进行基于证据的决策。本研究旨在从印度卫生系统的角度评估腹腔镜腹腔内补片修补术（IPOM）与开放式腹直肌后鞘修补术（VHR）相比的成本效益。
方法
对两种手术的结果进行Meta分析，同时从国家卫生系统成本数据库中获取成本估计值。
结果
对随机对照试验（RCT）的Meta分析显示，腹腔镜IPOM与开放技术在疝复发率方面的风险相似（RR：1.28，95%置信区间：0.81，2.04），但伤口感染风险显著降低（RR：0.31，95%置信区间：0.18，0.54）。与开放式疝修补术（36,166印度卢比）相比，国家卫生系统成本数据库（NHSCD）估计的每例VHR腹腔镜IPOM成本较高（58,872印度卢比），估计每避免一例伤口感染的增量成本效益比为5,023印度卢比。
结论
腹腔镜IPOM在疝复发方面临床效果不佳，且不太可能具有成本效益。
Zotero 插件