在儿童中, laparoscopic Nissen fundoplication 比开放的 Nissen fundoplication 更具成本效益
Niclas Högberg1,2, Johan Danielson3, Amanda Westblom3
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. niclas.hogberg@regionuppsala.se.
Pediatric surgery international
|January 17, 2025
概括
在儿童中, laparoscopic Nissen fundoplication (LNF) 比开放的Nissen fundoplication (ONF) 更具成本效益. LNF减少了住院时间和吗啡需求,结果相似,并发症较少.
科学领域:
- 儿科外科手术 儿科外科手术
- 胃肠病学 胃肠病学
- 卫生经济学 卫生经济学
背景情况:
- 尼森基囊复合是儿科胃食道逆流的常见程序.
- 之前在儿童中比较腹腔镜尼森基复合 (LNF) 和开放的尼森基复合 (ONF) 的研究已经产生了不确定的结果.
- 这项研究旨在比较一个机构的LNF与ONF的结果和经济方面.
研究的目的:
- 为了比较儿科患者LNF和ONF的临床结果.
- 评估LNF与ONF相比的经济影响和成本效益.
- 分析两个手术方法的手术,术后和出院后的参数.
主要方法:
- 在2011年至2017年间,对32名接受了尼森基囊移植的儿科患者进行了回顾性分析.
- 患者被分为两组:腹腔镜尼森基底复制 (LNF,n=18) 和开放的尼森基底复制 (ONF,n=14).
- 数据收集包括对患者日志的审查,分析手术前,手术后,术后和出院后的参数.
主要成果:
- 与ONF相比,LNF的操作时间 (165.2分 vs 216.6分) 和整体操作室持续时间 (315.0分 vs 334.9分) 显著缩短.
- 在LNF组经历了更短的术后住院时间 (3.8 vs 8.1天) 和需要更少的吗啡 (1.2 vs 1.7毫克/公斤).
- 每病例的总成本在LNF (261.1 vs 427.4 kSEK) 下降了39%,在术后并发症或结果上没有显著差异.
结论:
- 与开放手术相比, laparoscopic Nissen fundoplication 对儿科胃食道逆流是一种更具成本效益的手术选择.
- 在儿科患者中,LNF导致术后住院时间减少和吗啡需求降低.
- 该研究支持LNF作为一种有利的方法,因为它具有经济效益和可比的安全性.
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