Khoo A, Kroll S S, Reece G P, Miller M J, Evans G R, Robb G L, Baldwin B J, Wang B G, Schusterman M A
Department of Plastic Surgery at The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Plast Reconstr Surg. 1998 Apr;101(4):964-8; discussion 969-70. doi: 10.1097/00006534-199804040-00011.
The resource cost (cost to our hospital) of providing mastectomy plus breast reconstruction was calculated for 276 patients who had received both mastectomy and breast reconstruction at our institution. All patients had completed the entire reconstructive process, including reconstruction of the nipple. The resource costs of providing mastectomy with immediate breast reconstruction were compared with those of mastectomy with subsequent delayed reconstruction. We found that the mean resource cost for the 57 patients who had separate mastectomy followed by delayed breast reconstruction ($28,843) was 62 percent higher than that of mastectomy with immediate reconstruction ($17,801; n = 219, p < 0.001). Similar differences were found when patients were subgrouped by type of reconstruction (TRAM versus tissue expansion and implants), by laterality (unilateral versus bilateral), and by history of preoperative irradiation. We conclude that mastectomy with immediate breast reconstruction is significantly less expensive than mastectomy followed by delayed reconstruction and can potentially conserve resources.
我们计算了在本院接受乳房切除术加乳房重建的276例患者的资源成本（我院的成本）。所有患者均完成了整个重建过程，包括乳头重建。将即刻乳房重建的乳房切除术的资源成本与延迟乳房重建的乳房切除术的资源成本进行了比较。我们发现，57例先进行乳房切除术然后延迟乳房重建的患者的平均资源成本（28,843美元）比即刻重建的乳房切除术的平均资源成本（17,801美元；n = 219，p < 0.001）高62%。当按重建类型（横行腹直肌肌皮瓣与组织扩张及植入物）、侧别（单侧与双侧）和术前放疗史对患者进行亚组分析时，也发现了类似差异。我们得出结论，即刻乳房重建的乳房切除术比延迟重建的乳房切除术成本显著更低，并且有可能节省资源。
