Cost comparison analysis of laparoscopic versus open aortobifemoral bypass surgery: a randomized controlled trial

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Open Access Journal of Clinical Trials Pub Date : 2019-06-19 DOI:10.2147/OAJCT.S192552
M. Sahba, A. H. Krog, E. M. Pettersen, T. Wisløff, Kg Rogne, J. Sundhagen, Ssh Kazmi
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引用次数: 3

Abstract

1Department of Vascular Surgery, Ostfold Central Hospital, Grålum, Norway; 2Department of Vascular Surgery, Sørlandet Hospital HF, Kristiansand, Norway; 3Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway; 4Department of Health Management and Health Economics, University of Oslo, Oslo, Norway; 5Economy Department, Oslo University Hospital, Oslo, Norway; 6Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway; 7Faculty of Medicine, Oslo University, Oslo, Norway Background: Laparoscopic aortobifemoral bypass (LABFB) surgery has become an established treatment procedure for aortoiliac occlusive disease (AIOD), Trans-Atlantic Inter-Society Consensus II (TASC II), type D lesions. However, studies with an economic evaluation of this procedure are sparse. The main purpose of our study was to compare the costs of LABFB and open aortobifemoral bypass (OABFB) surgery. Patients and methods: This is a substudy of a larger randomized controlled prospective multicenter trial, Norwegian Laparoscopic Aortic Surgery Trial (NLAST). Perioperative data were collected on 70 patients undergoing surgery for AIOD, TASC type D lesions. Thirty-four patients were randomized to LABFB and 36 patients to OABFB. Treatment costs were calculated for the two operative treatments until 30 postoperative days. In addition to fixed and variable costs, direct and indirect costs were also included. Results: The mean total cost of LABFB was 19,798 € and for OABFB 34,016 € until 30 postoperative days. Laparoscopic procedure was 14,218 € less costly than the open procedure. The main factor leading to less cost of LABFB was shorter length of hospital stay (mean 5.3 days, 95% CI 4.1–6.5) as compared to OABFB (mean 10.1 days, 95% CI 7.5–12.6). Ten patients, three in the LABFB and seven in the OABFB group, had complications that resulted in reoperations within the 30 postoperative days. The mean cost of treatment for the complicated patients was 49,349 € and 82,985 €, respectively, for LABFB and OABFB. Conclusion: Laparoscopic aortobifemoral bypass procedure costs less than open aortobifemoral bypass for the treatment of advanced aortoiliac occlusive disease.
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腹腔镜与开放式主动脉-股动脉旁路手术的成本比较分析:一项随机对照试验
1挪威Grålum Ostfold中央医院血管外科;2挪威克里斯蒂安桑瑟兰德HF医院血管外科;3挪威公共卫生研究所传染病流行病学和建模系,挪威奥斯陆;4挪威奥斯陆奥斯陆大学卫生管理和卫生经济学系;5经济科,奥斯陆大学医院,奥斯陆,挪威;6奥斯陆大学医院心血管和肺部疾病科血管外科,挪威奥斯陆;7奥斯陆大学医学院,奥斯陆,挪威背景:腹腔镜主动脉-双股旁路(LABFB)手术已成为主动脉-髂动脉闭塞性疾病(AIOD)、跨大西洋社会共识II(TASC II)和D型病变的既定治疗程序。然而,对该程序进行经济评估的研究很少。我们研究的主要目的是比较LABFB和开放性主动脉双股旁路(OABFB)手术的成本。患者和方法:这是一项更大的随机对照前瞻性多中心试验,挪威腹腔镜主动脉外科试验(NLAST)的子研究。收集了70名接受AIOD、TASC D型病变手术的患者的围手术期数据。34名患者被随机分配到LABFB,36名患者被分配到OABFB。计算两次手术治疗至术后30天的治疗费用。除了固定成本和可变成本外,还包括直接成本和间接成本。结果:术后30天,LABFB和OABFB的平均总费用分别为19798欧元和34016欧元。腹腔镜手术比开放式手术成本低14218欧元。与OABFB(平均10.1天,95%置信区间7.5-12.6)相比,导致LABFB费用降低的主要因素是住院时间更短(平均5.3天,95%可信区间4.1-6.5)。10名患者(LABFB组3名,OABFB组7名)出现并发症,导致术后30天内再次手术。LABFB和OABFB的复杂患者的平均治疗费用分别为49349欧元和82985欧元。结论:腹腔镜主动脉-双股动脉搭桥术治疗晚期主动脉-髂动脉闭塞性疾病的成本低于开放式主动脉-双足动脉搭桥术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Open Access Journal of Clinical Trials
Open Access Journal of Clinical Trials MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.90
自引率
0.00%
发文量
2
审稿时长
16 weeks
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