Volume : 6, Issue : 5, May - 2017

CLINICAL STUDY OF INGUINAL HERNIA WITH SPECIAL REFERENCE TO COST OF TREATMENT

Dr. Tarun Kumar Sainia, Dr. Shrikant Sharma, Dr Swagata Brahamchari, Dr Mahesh Ram

Abstract :

<p>&nbsp;<b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,serif;&#10;color:windowtext;mso-bidi-font-style:italic">Aim</span></b><span style="font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif; color: windowtext;">: 1.To evaluate pre-operative, operative &nbsp;and postoperative cost in inguinal hernia, and to see&nbsp; the total cost of different operative procedures for management of inguinal hernia. 2. To evaluate the economic impact in relation to pre &amp; post operative hospital stay.</span></p> <p class="MsoNormal"><b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,serif;&#10;color:windowtext">Material and Methods </span></b><span style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,serif;color:windowtext">: </span><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,serif;&#10;color:#2E2E2E">This study is a cost effectiveness analysis within a randomized controlled trial comparing open (OPEN) versus laparoscopic (LAP) hernia repair using mesh in&nbsp; Department of&nbsp; surgery with 6 months &nbsp;followup for each patient. Between January 2015&nbsp; and&nbsp; September 2016.&nbsp; men with inguinal hernia were randomized and&nbsp; had an operation;&nbsp; patients (-75- OPEN and -25-LAP) with outpatient hernia operations were included in the cost effectiveness analysis. Outcomes included preoperative ,surgical and postoperative costs.</span><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,serif;&#10;color:windowtext"><o:p></o:p></span></p> <p class="MsoNormal"><b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,serif;&#10;color:windowtext">Results</span></b><span style="font-size:12.0pt;line-height:&#10;115%;font-family:&quot;Times New Roman&quot;,serif;color:windowtext"> : </span><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,serif;&#10;color:#2E2E2E">Cost effectiveness analysis within a randomized controlled trial comparing open (OPEN) versus laparoscopic (LAP) hernia repair using mesh was done and it was seen that </span><span style="font-size:12.0pt;line-height:&#10;115%;font-family:&quot;Times New Roman&quot;,serif;color:windowtext">total cost in open hernia repair is 25958 [around 26000] whereas in laparoscopic it is 66478 .Significant difference was found in the intraoperative cost in open as compared&nbsp; to laparoscopic ,and there was also significant difference in the post op stay&nbsp; which wasmore in open repairs.<o:p></o:p></span></p> <p class="MsoNormal"><b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,serif;&#10;color:windowtext">Conclusion</span></b><span style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,serif;color:windowtext"> : Laparoscopic repair although costly but has many advantages like small incision ,less hospital stay ,more patient satisfaction and early recovery. Open hernia repair though cost effective has limitations of&nbsp; large incision ,more hospital stay ,greater no of I.V. antibiotics and&nbsp; late&nbsp; recovery. But still in a poor ,developing country like India&nbsp; open method is still the method of preference as it involves significantly lower costs .<b><o:p></o:p></b></span></p>