Guleria Charu, Kumar Dinesh, Sahoo Krushna Chandra
Dr. Rajendra Prasad Government Medical College, Kāngra, India.
Department of Health Research, New Delhi, India.
Cost Eff Resour Alloc. 2025 Jun 10;23(1):27. doi: 10.1186/s12962-025-00638-4.
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.
A Meta-analysis of outcomes of both procedures was carried out whereas cost estimates were obtained from national health system costing database.
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.
Laparoscopic IPOM was not clinically effective in hernia recurrence and less likely to be cost-effective.
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。
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。
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。
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。
