A cost-utility analysis of laparoscopic vs open treatment of colorectal cancer in a public hospital of the Greek National Health System.
A cost-utility analysis of laparoscopic vs open treatment of colorectal cancer in a public hospital of the Greek National Health System.
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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：
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Georgios Zografos
中科院分区：
文献类型：
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作者：
N. Michalopoulos;G. Theodoropoulos;P. Stamopoulos;T. Sergentanis;N. Memos;D. Tsamis;I. Flessas;E. Menenakos;N. Kontodimopoulos;Georgios Zografos
目的
腹腔镜结肠切除术已被报道为一种安全和肿瘤相似的手术开放结肠切除术。手术过程中需要一些昂贵的手术器械，如果对患者和整个卫生系统具有成本效益，则应采用这种手术。本研究的目的是在希腊国家卫生系统中对腹腔镜结肠切除术与开腹结肠切除术治疗结肠癌进行经济学评价。
方法
50例接受开放性结肠切除术的患者和42例接受腹腔镜结肠切除术的患者入组本病例对照研究。记录基线、术后1个月和3个月时的住院时间、手术持续时间、并发症发生率、所用设备成本、总成本和3份测量生活质量/QoL（EQ-5D、SF-36和QLQ-C30）的问卷。
结果
在腹腔镜和开放性结肠切除术之间，通过QOLS测量的QoL无统计学显著差异。另一方面，成本效用分析显示，腹腔镜结肠切除术更昂贵，考虑到它提供的优势。
结论
在希腊公立医院系统中，腹腔镜结肠切除术在QoL基础上并不上级开腹结肠切除术，并且与开腹手术相比，腹腔镜结肠切除术的成本效益较低。由于腹腔镜结肠切除术中使用的昂贵设备似乎是这种手术成本高的原因，因此应努力通过使用可重复使用的器械或实施旨在降低设备费用的政策来降低成本。
PURPOSE
Laparoscopic colectomy has been reported as a safe and oncologically similar operation to open colectomy. A number of expensive surgical instruments are necessary for the procedure which should be applied if it is cost-effective for the patient and the health system in general. The purpose of the current study was the economic evaluation of laparoscopic compared to open colectomy for the treatment of colon cancer in the Greek national health system.
METHODS
Fifty patients undergoing open colectomy and 42 undergoing laparoscopic colectomy were enrolled in this case-control study. Length of hospital stay, duration of operation, complication rates, cost of equipment used, total costs and three questionnaires measuring quality of life /QoL (EQ-5D, SF-36 and QLQ-C30) at baseline, 1 and 3 months after the operation were recorded.
RESULTS
No statistically significant difference in QoL measured by QALYs between laparoscopic and open colectomy was observed. On the other hand, cost utility analysis revealed that laparoscopic colectomy was more expensive considering the advantages it offers.
CONCLUSIONS
Laparoscopic colectomy is not superior to open colectomy on a QoL basis in the Greek public hospital system and is less cost-effective compared to the open procedure. Since the expensive equipment used in laparoscopic colectomy seems to be the causative factor for the high cost of this type of operation, an effort should be made to reduce it either by using reusable instruments or by implementing policies aiming at suppliers cutting down equipment charges.