Damamme A, Samama G, D'Alche-Gautier M J, Chanavel N, Bréfort J L, Le Roux Y
Service de Chirurgie Générale Viscérale et Digestive, CHU Côte de Nacre, Caen.
Ann Chir. 1998;52(1):11-6.
Between May 1994 and September 1995, 64 men were included in a randomized prospective study comparing conventional Shouldice repair (S group) and transperitoneal laparoscopic repair with polypropylene mesh (L group). Cost evaluation was divided into distinct parts: drugs, non usable surgical materials, medico-technical procedures food and employees costs. In group S, mean operating time was 56', total cost was 3,922 FF in the case of unilateral hernia and 4,808 FF and respectively 77' in the case of bilateral hernia. In group L, mean operative time was 89', total cost 8,949 FF (disposable trocars) and 7,136 FF (non-disposable trocars) in the case of unilateral hernia and 116', 9,570 FF and 7,763 FF in case of bilateral hernia. Postoperative stay was 4.2 days in group S and 4 days in group L. Return to work was 28.6 days in group L and 35.5 days in group S (ns). In conclusion laparoscopic hernia repair does not decrease post operative pain, hospital stay and return to work, but is twice as expensive.
1994年5月至1995年9月期间，64名男性被纳入一项随机前瞻性研究，比较传统的Shouldice修补术（S组）和经腹腹腔镜聚丙烯网片修补术（L组）。成本评估分为不同部分：药物、不可用手术材料、医疗技术程序、食品和员工成本。在S组中，单侧疝的平均手术时间为56分钟，总成本为3922法郎；双侧疝的平均手术时间为77分钟，总成本为4808法郎。在L组中，单侧疝的平均手术时间为89分钟，使用一次性套管针时总成本为8949法郎，使用非一次性套管针时总成本为7136法郎；双侧疝的平均手术时间为116分钟，使用一次性套管针时总成本为9570法郎，使用非一次性套管针时总成本为7763法郎。S组的术后住院时间为4.2天，L组为4天。L组的复工时间为28.6天，S组为35.5天（无显著性差异）。总之，腹腔镜疝修补术不会减少术后疼痛、住院时间和复工时间，但成本是传统修补术的两倍。
