Assessing the economic advantage of laparoscopic vs. open approaches for colorectal cancer by a propensity score matching analysis
Assessing the economic advantage of laparoscopic vs. open approaches for colorectal cancer by a propensity score matching analysis
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通过倾向评分匹配分析评估腹腔镜与开放式结直肠癌手术的经济优势
DOI：
10.1007/s00595-017-1606-7
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发表时间：
2018
期刊：
影响因子：
2.5
通讯作者：
Takamori Hiroshi
中科院分区：
文献类型：
--
作者：
Hayashi Hiromitsu;Ozaki Nobuyuki;Ogawa Katsuhiro;Ikuta Yoshiaki;Tanaka Hideyuki;Ogata Kenichi;Doi Koichi;Takamori Hiroshi
PurposesThis study investigated the surgical outcome and potential economic advantage of open vs. laparoscopic surgery for colorectal cancer using a propensity score matching analysis.MethodsWe investigated the surgical and economic outcomes of patients undergoing laparoscopic（N= 127）and open surgery（N= 253）for colorectal cancer and then compared these outcome in two groups结果与开放手术相比，腹腔镜手术的总体发病率显著降低，（14 vs. 40%;P< 0.001）和平均（±标准差）术后住院时间更短（分别为12.6 ± 8.3 vs. 16.8 ± 9.9天;P= 0.001）。尽管平均手术费用（日元）较高（985，000 ± 215，000 vs. 812，000 ± 222，000日元;P< 0.001），但使用腹腔镜方法显著降低了非手术费用（773，000 ± 440，000 vs. 1075，000 ± 508，000日元;P< 0.001）。腹腔镜辅助手术的平均总费用（175.8万± 57.6万日元）比开腹手术减少了约13万日元（1886，000 ± 619，000日元），尽管差异没有统计学意义结论腹腔镜手术治疗结直肠癌在降低发病率和促进早期出院方面具有优势，且不增加住院费用。这些发现与支持腹腔镜手术作为微创方法的益处的普遍共识一致。
PurposesThis study investigated the surgical outcomes and potential economic advantage of open vs. laparoscopic surgery for colorectal cancer using a propensity score matching analysis.MethodsWe examined the surgical and economic outcomes of patients undergoing laparoscopic (N= 127) and open surgery (N= 253) for colorectal cancer and then compared these outcomes in two groups (N= 103 each) using a propensity score matching analysis.ResultsCompared to open surgery, the laparoscopic approach was associated with a significantly lower overall morbidity rate (14 vs. 40%;P< 0.001) and shorter mean (± standard deviation) postoperative hospital stay (12.6 ± 8.3 vs. 16.8 ± 9.9 days, respectively;P= 0.001). Despite generating higher mean surgical costs (Japanese yen) (985,000 ± 215,000 vs. 812,000 ± 222,000 yen;P< 0.001), utilizing a laparoscopic approach significantly reduced the non-surgical costs (773,000 ± 440,000 vs. 1075,000 ± 508,000 yen;P< 0.001). The mean total cost of laparoscopic-assisted surgery (1758,000 ± 576,000 yen) was decreased by approximately 130,000 yen compared with open surgery (1886,000 ± 619,000 yen), although the difference was not statistically significant (P= 0.125).ConclusionsLaparoscopic surgery for colorectal cancer is advantageous in reducing morbidity and facilitating an early discharge and does not increase hospital costs. These findings are consistent with the general consensus supporting the benefits of laparoscopic surgery as a minimally invasive approach.
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影响因子：
16.9
作者：
Crawshaw, Benjamin P.;Chien, Hung-Lun;Delaney, Conor P.
通讯作者：
Delaney, Conor P.
影响因子：
168.9
作者：
Lacy, AM;García-Valdecasas, JC;Visa, J
通讯作者：
Visa, J
希腊国家卫生系统公立医院腹腔镜与开腹治疗结直肠癌的成本效用分析。
DOI：
--
发表时间：
2013
期刊：
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
影响因子：
--
作者：
N. Michalopoulos;G. Theodoropoulos;P. Stamopoulos;T. Sergentanis;N. Memos;D. Tsamis;I. Flessas;E. Menenakos;N. Kontodimopoulos;Georgios Zografos
通讯作者：
Georgios Zografos
未能预防手术部位感染的财务影响
影响因子：
1.2
作者：
Karen W. Sparling;F. Ryckman;P. Schoettker;T. Byczkowski;Alma Helpling;Keith E Mandel;Anitha Panchanathan;U. Kotagal
通讯作者：
U. Kotagal
腹腔镜手术与开腹手术治疗直肠癌
DOI：
10.1056/nejm-jw.na37360
发表时间：
2015
期刊：
NEJM Journal Watch
影响因子：
--
作者：
H. Kuerer
通讯作者：
H. Kuerer