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Cost-utility analysis comparing laparoscopic vs open aortobifemoral bypass surgery
Anne Helene Krog1,2, Mehdi Sahba3, Erik M Pettersen4
1Institute of Clinical Medicine, Faculty of Medicine, University of Oslo.
Vascular Health and Risk Management
|July 4, 2017
Summary
Totally laparoscopic aortobifemoral bypass offers improved quality-adjusted life years (QALYs) and lower costs compared to open surgery. This minimally invasive approach demonstrates significant benefits for patients with aortoiliac obstructive disease.
Area of Science:
- Vascular Surgery
- Minimally Invasive Procedures
- Health Economics
Background:
- Aortoiliac obstructive disease necessitates effective surgical interventions.
- Laparoscopic surgery presents a minimally invasive alternative to open procedures.
- Assessing the economic and quality-of-life impact of surgical techniques is crucial.
Purpose of the Study:
- To compare quality-adjusted life years (QALYs) and costs between totally laparoscopic and open aortobifemoral bypass.
- To evaluate the long-term health-related quality of life following these procedures.
Main Methods:
- Prospective randomized controlled trial (Norwegian Laparoscopic Aortic Surgery Trial).
- Fifty patients with symptomatic aortoiliac occlusive disease randomized to laparoscopic (n=25) or open (n=25) bypass.
- Health-related quality of life measured using EuroQol (EQ-5D-5L) at baseline and during 6-month follow-up.
- QALYs calculated using area under the curve; costs analyzed based on procedure, equipment, and hospital stay.
Main Results:
- Laparoscopic bypass resulted in a significantly higher increase in QALYs (0.07 difference, p=0.001).
- Total costs were substantially lower for laparoscopic surgery (€9,953) versus open surgery (€17,260, p=0.001).
Conclusions:
- Totally laparoscopic aortobifemoral bypass is a cost-effective treatment for aortoiliac obstructive disease.
- The procedure offers superior QALY gains and reduced procedural costs compared to open surgery.
