背景:与开放修补术相比,机器人辅助腹侧疝修补术与住院时间缩短和并发症发生率降低相关,但是机器人系统的获取和维护成本很高。这项研究的目的是比较机器人辅助和开放式腹侧和切口疝修补术的特定程序成本,包括术后90天内与程序相关的再入院和再手术的成本。
方法:单中心回顾性队列研究,纳入100例机器人辅助腹侧疝患者。患者的倾向评分为1:1,100例患者接受开放修复的年龄,类型的疝(原发性/切口),和水平缺陷的大小。该研究的主要结果是以欧元为单位的每个程序的总成本,包括机器人方法的成本,额外的端口,网格,屠夫,逗留时间,重新接纳的长度,和手术再干预。机器人本身的成本不包括在成本计算中。
结果:接受机器人辅助腹侧疝修补术的患者平均住院时间为0.3天,与接受开放修复的患者的2.1天相比,P<0.005。接受机器人辅助腹侧疝修补术的患者的再入院率为4%,与开放式修补术(17%)相比明显更低。P=0.006。所有机器人辅助腹侧和切口疝修补术的平均总成本为1,094欧元,而开放式修补术为1,483欧元,P=0.123。与开放式腹侧疝修补术(2,169欧元)相比,机器人辅助切口疝修补术的总成本显着降低(1,134欧元),P=0.005。
结论:在一个丹麦的切口疝患者队列中,由于住院时间缩短,机器人辅助切口疝修补术比开放式修补术更具成本效益,90天内再入院和再干预率较低。
BACKGROUND: Robot-assisted ventral hernia repair is associated with decreased length of stay and lower complication rates compared with open repair, but acquisition and maintenance of the robotic system is costly. The aim of this was
study was to compare the procedure-specific cost of robot-assisted and open ventral and incisional hernia repair including cost of procedure-related readmissions and reoperations within 90 days postoperatively.
METHODS: Single-center retrospective cohort
study of 100 patients undergoing robot-assisted ventral hernia. Patients were propensity-score matched 1:1 with 100 patients undergoing open repairs on age, type of hernia (primary/incisional), and horizontal defect size. The primary outcome of the
study was the total cost per procedure in Euros including the cost of a robotic approach, extra ports, mesh, tackers, length of stay, length of readmission, and operative reintervention. The cost of the robot itself was not included in the cost calculation.
RESULTS: The mean length of stay was 0.3 days for patients undergoing robot-assisted ventral hernia repair, which was significantly shorter compared with 2.1 days for patients undergoing open repair, P < 0.005. The readmission rate was 4% for patients undergoing robot-assisted ventral hernia repairs and was significantly lower compared with open repairs (17%), P = 0.006. The mean total cost of all robot-assisted ventral and incisional hernia repairs was 1,094 euro compared with 1,483 euro for open repairs, P = 0.123. The total cost of a robot-assisted incisional hernia repair was significantly lower (1,134 euros) compared with open ventral hernia repair (2,169 euros), P = 0.005.
CONCLUSIONS: In a Danish cohort of patients with incisional hernia, robot-assisted incisional hernia repair was more cost-effective than an open repair due to shortened length of stay, and lower rates of readmission and reintervention within 90 days.