Evaluation of the cost for laparoscopic-assisted Billroth I gastrectomy
Evaluation of the cost for laparoscopic-assisted Billroth I gastrectomy
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DOI：
10.1007/s004640090089
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发表时间：
2001-09-01
影响因子：
3.1
通讯作者：
Kitano, S
中科院分区：
文献类型：
--
作者：
Adachi, Y;Shiraishi, N;Kitano, S
背景：尽管腹腔镜胃手术在日本迅速普及，但还没有人评估这项新技术的成本。本研究的目的是分析和比较医院的费用腹腔镜辅助胃切除术与传统的开放gastrectomy.Methods：本研究包括48例连续的患者进行腹腔镜辅助Billroth我胃切除术和43例谁有一个传统的开放Billroth我胃切除术治疗早期胃癌1994年5月至2000年4月。住院费用包括住院期间发生的所有费用，他们分为咨询，处方，注射，护理，手术室，实验室，放射科，病房和膳食，和others.Results：腹腔镜胃切除术的患者与开腹胃切除术的患者在症状，并发症，手术时间，近端切缘，收获淋巴结的数量相似。和疾病的阶段。腹腔镜胃切除术后住院时间明显短于开腹胃切除术后（16.1比20.5天，P < 0.01）。护理费、病房费、餐费。腹腔镜组住院总费用低于开腹组（Y 5800 vs Y8010，p < 0.01; Y 461 x 10（3）vs Y512 x 10（3），p < 0.05; Y1336 x 10（3）vs Y1411 x 10（3），p = 0.072）。当我们比较1994-96年与1997-2000年的腹腔镜胃切除术时，我们发现病房和膳食费用以及总住院费用有所下降（Y498 x 10（3）vs Y421 x 10（3），P < 0.01; Y1390 x 10（3）vs Y1277 x 10（3），P < 0.01）。腹腔镜检查-辅助Billroth I胃切除术比传统的开放Billroth I胃切除术更便宜，因为术后恢复期和住院时间短.在接受胃切除术的患者中，一次性器械的额外成本可以通过与腹腔镜胃切除术相关的较低的病房和膳食以及护理费用完全抵消。
Background: Despite the rapid spread of laparoscopic gastric surgery in Japan, no one has yet evaluated the costs for this new technique. The aim of this study was to analyze and compare the hospital charges for laparoscopic-assisted gastrectomy with those for conventional open gastrectomy.Methods: The study included 48 consecutive patients who underwent laparoscopic-assisted Billroth I gastrectomy and 43 who had a conventional open Billroth I gastrectomy for cure of early gastric cancer between May 1994 and April 2000. Hospital charges covered all costs incurred during the hospital stay; they were divided into charges for consultation, prescription, injection, nursing care, operating theater, laboratory, radiology, ward and meal, and others.Results: The patients who underwent laparoscopic gastrectomy were similar to those who had open gastrectomy in terms of symptoms, concurrent illness, operation time, proximal resection margin, number of harvested lymph nodes. and stage of the disease. Hospital stay after laparoscopic gastrectomy was shorter than that after open gastrectomy (16.1 vs 20.5 days, p < 0.01). Charges for nursing care, charges for ward and meal. and total hospital charges were less in the laparoscopic group than in the open roup (Y5800 vs Y8010, p < 0.01; Y461 x 10(3) vs Y512 x 10(3), p < 0.05; Y1336 x 10(3) vs Y1411 x 10(3), p = 0.072). When we compared laparoscopic gastrectomies performed during 1994-96 with those done during 1997-2000, we found a decrease in charges for ward and meal and total hospital charges (Y498 x 10(3) vs Y421 x 10(3), P < 0.01; Y1390 x 10(3) vs Y1277 x 10(3), P < 0.01).Conclusion: Laparoscopic-assisted Billroth I gastrectomy is less expensive than conventional open Billroth I gastrectomy because both the postoperative recovery period and the hospital stay are shorter. In patients who undergo gastrectomy, the additional costs of the disposable instruments can be fully offset by the lower charges for ward and meal and nursing care associated with laparoscopic gastrectomy.