Kabalin J N, Butler E D
Veterans Affairs Medical Center, Palo Alto, CA 94304, USA.
West J Med. 1995 May;162(5):426-9.
We reviewed hospital charges for patients undergoing uncomplicated endoscopic surgical resection for symptomatic bladder outlet obstruction due to benign prostatic hyperplasia over a 1-year period at a single institution. Of 115 patients, 67 underwent transurethral electrocautery resection of the prostate, and 48 underwent endoscopic neodymium:yttrium-aluminum-garnet laser ablation of the prostate under direct vision. Analysis showed a cost differential between these 2 surgical treatments in excess of $2,000, favoring laser prostatectomy (P < .0001) over transurethral electrocautery resection. The single greatest difference between the treatments was the ability to manage all patients receiving laser treatment as outpatients, whereas the mean and median hospital stay after transurethral electrocautery resection was 3.0 days. Taking additional cost variables into account and decreasing the cost of laser delivery systems would further increase this cost differential in favor of laser therapy. The diminished postoperative morbidity associated with laser treatment also promises lower total costs over the long term.
我们回顾了在一家机构中，一年内因良性前列腺增生导致症状性膀胱出口梗阻而接受单纯内镜手术切除的患者的住院费用。在115名患者中，67例行经尿道前列腺电切术，48例行直视下内镜钕:钇铝石榴石激光前列腺切除术。分析显示，这两种手术治疗的费用差异超过2000美元，激光前列腺切除术比经尿道前列腺电切术更具优势（P < .0001）。两种治疗方法之间最大的差异在于，接受激光治疗的所有患者都能作为门诊病人处理，而经尿道前列腺电切术后的平均和中位住院时间为3.0天。考虑到其他成本变量并降低激光输送系统的成本，将进一步加大这种成本差异，使激光治疗更具优势。与激光治疗相关的术后发病率降低，也预示着从长期来看总成本会更低。
