«Cost–utility» analysis of treatment of inguinal hernia with non-stretching methods

The the introduction of new technologies into the practice of the surgeon made definition of the ratio for costs and utility for health when choosing open or endoscopic methods of treatment of inguinal herniа to be an important issue.

Patients and methods. In the work we analyzed data of 43 men, who underwent Lichtenstein inguinal hernia repair (n=27) and totally extraperitoneal laparoscopic inguinal hernia repair (TEP, n=16). Quality of life indicators were determined before, after and 12 months after surgery, based on the assessment on a scale of «health thermometer», which were then used to calculate the QALY. The intensity of pain was recorded on visual-analog scale. We conducted «cost–utility» analysis with the use of direct costs for calculations

Results. We demonstrated that patients, who underwent Lichtenstein surgery QALY increment was up to 0.22 and TEP – 0.36. The intensity of pain after surgery was less evident after TEP. Cost-utility ratio in the case of Lichtenstein surgery was 293,112.7 rubles/QALY, and TEP – 260,080.0 rubles/QALY.

Conclusion. Repair according to TEP method was dominant from the standpoint of the conducted clinical and economic analysis.

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