EVALUATION OF INGUINAL REPAIR EFFECTIVENESS BASED ON «COST-UTILITY» ANALYSIS

Abstract

Taking into account new technologies practical application, the evaluation of correlation between the expired costs and obtained utility for health is important today in the context of choice between open-cut and laparoscopic inguinal hernia treatment methods. Purpose of the study. The «cost-utility» analysis of the inguinal hernia treatment with the use of the Lichtenstein tension-free method and the laparoscopic transabdominal preperitoneal hernia repair method. Material and methods. The retrospective comparative analysis of 52 men underwent the laparoscopic transabdominal preperitoneal hernia repair (TAPP, n = 25) and the Lichtenstein tension-free method ( n = 27) has been carried out. The indicators of life quality were estimated by the scale «thermometer-health» before, after and in 6 months after surgery and than the indicators were used for QALY calculation. The intensity of pain after surgery was registered with visual-analog scale. The «cost-utility» analysis was carried out with direct expenses use. Results and discussion. The QALY increment was 0,10 in the patients underwent Lichtenstein tension-free method and 0,17 in the patients underwent TAPP. The postoperative pain syndrome intensity was less expressed after TAPP. The «cost-utility»coefficient was 644848,0 rub/QALY in case of Lichtenstein method, and 550796,5 rub/QALY for TAPP. Thus, the hernioplasty by TAPP method is dominant from the point of view of the carried-out clinical and economic analysis.