Cost analysis of three different surgical procedures for treatment of a pelvic tumour

作     者：Bruns, J Luessenhop, S Behrens, P 

作者机构：Univ Hamburg Ctr Biomech Dept Orthopaed Surg D-20246 Hamburg Germany 

出 版 物：《LANGENBECKS ARCHIVES OF SURGERY》 (朗恩贝克外科学文献)

年 卷 期：1998年第383卷第5期

页      面：359-363页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：pelvic tumour cost analysis hemipelvectomy ileo-femoral pseudoarthrosis endoprosthetic pelvic replacement 

摘      要：Introduction: Malignant pelvic tumours are rare, but adequate treatment is difficult because of anatomical and functional reasons. Different surgical procedures are recommended. Besides aspects influencing the quality of lift: due to the different surgical techniques, costs of these surgical procedures and the perioperative time interval, depending on the chosen surgical procedure, must also be considered. Methods: Costs of three kinds of surgical treatment - internal hemipelvectomy vs external hemipelvectomy and application of an orthotic device vs ilio-femoral pseudoarthrosis - were compared, including costs of the immediate period of rehabilitation. Costs of the preoperative diagnostic procedure were excluded because they were assumed to be equal. For all calculations, treatment of a periacetabular pelvic tumour type II-b was assumed, according to the Enneking classification, with the need for a pelvic resection with wide margins including removal of the hip joint. This analysis was performed based on the average costs per hour of physicians, nurses and physiotherapists, including a basic daily rate for additional costs, such as housekeeping and administrative costs of the hospital. In all cases, the costs of the operative procedure and the perioperative period up to 3 months were calculated, including the costs for the endoprosthetic device after internal hemipelvectomy and those for the orthotic devices after necessary external hemipelvectomy. Results: For a postoperative period of 3 months, the cost for treatment with resection of the tumour and performing an ilio-femoral pseudoarthrosis is nearly DM 56,741.54;treatment with an internal hemipelvectomy including the endoprosthetic pelvic replacement costs DM 81,439.34;and treatment with external hemipelvectomy and application of an orthotic device with a pelvic cage costs DM 69,138.46. In this analysis, social costs due to the different rates of disability for years or costs of a new prosthetic device after yea