The outcomes and cost analysis of open repair and endovascular aneurysm repair for abdominal aortic aneurysms: a single-center experience in Japan.

IF 1.7 4区医学 Q2 SURGERY Surgery Today Pub Date : 2024-09-04 DOI:10.1007/s00595-024-02934-7

Yasumi Maze, Toshiya Tokui, Ryotaro Inoue, Tomotake Sekoguchi, Takahiro Narukawa, Masahiko Murakami, Ryosai Inoue, Koji Hirano, Shuji Chino, Ken Nakajima, Noriyuki Kato, Hisato Ito

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引用次数: 0

Abstract

Purpose: Japan has adopted its own reimbursement system, which differs from other countries in terms of its diagnostic procedure combination (DPC) methods. However, there are few reports on the cost analysis of open repair and endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms in Japan. We aimed to evaluate the long-term outcomes and cost-effectiveness of these two procedures.

Methods: This study included patients who underwent open repair (n = 224) and EVAR (n = 87) between January 2012 and December 2022. After propensity score matching, we compared the two groups.

Results: The drug and blood products, procedures, and DPC costs were significantly higher in the open repair group (p < 0.001) than in the EVAR group. The surgical equipment and total costs were significantly higher in the EVAR group than in the open repair group (p < 0.001). There was no significant difference in the 5-year survival rate (88.5% in the open repair group vs. 72.0% in the EVAR group; p = 0.33) and freedom from re-intervention rate at 5 years (93.1% in the open repair group vs. 89.9% in the EVAR group; p = 0.15) between the two groups.

Conclusions: Open repair is more cost-effective than EVAR. The cost-effectiveness of EVAR may therefore depend on the cost of the endograft.

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腹主动脉瘤开放式修补术和血管内动脉瘤修补术的疗效和成本分析：日本单中心经验。

目的：日本采用自己的报销制度，其诊断程序组合（DPC）方法与其他国家不同。然而，关于日本腹主动脉瘤开放式修补术和血管内动脉瘤修补术（EVAR）的成本分析报告却很少。我们旨在评估这两种手术的长期疗效和成本效益：本研究纳入了 2012 年 1 月至 2022 年 12 月间接受开放式修复术（224 例）和 EVAR（87 例）的患者。经过倾向评分匹配后，我们对两组患者进行了比较：结果：开放式修复组的药物和血液制品、手术和 DPC 成本明显更高（p 结论：开放式修复比 EVAR 更具成本效益：开放式修复比 EVAR 更具成本效益。因此，EVAR 的成本效益可能取决于内植物的成本。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.