Surgical outcome and cost-minimisation-analyses of laparoscopic and open hernia repair: a randomised prospective trial with one year follow up.
OBJECTIVE
To compare outcome and costs between laparoscopic and open hernia repair.


METHODS
Prospective randomised study.


METHODS
One university and two district hospitals in Sweden.


METHODS
200 men aged 25-75 years.


METHODS
Operating time, hospital stay, complications, and time to recovery. A cost-minimisation-analysis was used in which the total costs were calculated for a defined period of time for each option.


RESULTS
The one year follow-up rate was 98%. Mean (SD) operation times in the laparoscopic and open groups were 72 (30) and 62 (25) minutes, respectively (p = 0.009). Hospital stay and complication rates did not differ between the groups. Among employees the mean (SD) periods off work in the laparoscopic and open groups were 10 (8) and 23 (21) days, respectively (p = 0.0001). The mean direct costs of the laparoscopic operation were increased by SEK 4037 (US$ 483) but the savings in indirect costs resulting from earlier return to work were SEK 11392 (US$ 1364).


CONCLUSIONS
Laparoscopic hernia repair gave the employed patients faster recovery and return to work, and was the most cost-effective strategy provided that both direct and indirect costs were included.
Kald
A
A
Department of Surgery, University of Linköping, Sweden.
Anderberg
B
B
Carlsson
P
P
Park
P O
PO
Smedh
K
K
D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000191:economics / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000191:economics* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics*; D011336:Probability; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000191:economics* / Q000379:methods; D013548:Sweden; D016896:Treatment Outcome