Article 5319

Title of the article

COMPARATIVE EVALUATION OF THE CLINICAL AND ECONOMIC EFFICIENCY OF INTRA-ABDOMINAL HERNIOPLASTY WITH A COMBINED ENDOPROSTHESIS (FROM BIOLOGICAL AND SYNTHETIC MATERIALS) AND A POLYPROPYLENE MESH WITH ANTI-ADHESIVE COATING 

Authors

Feoktistov Yaroslav Evgen'evich, Assistant, sub-department of surgery, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: feoctistovi@gmail.com
Nikol'skiy Valeriy Isaakovich, Doctor of medical sciences, professor, sub-department of surgery, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: nvi61@yandex.ru
Titova Ekaterina Valer'evna, Candidate of medical sciences, associate professor, sub-department of surgery, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: kineta@yandex.ru
Feoktistova Elena Gennad'evna, Candidate of medical sciences, associate professor, sub-department of surgery, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: eyutkina@bk.ru
Ogorodnik Elena Viktorovna, Student, Medical Institute, Penza State University (40 Krasnaya street, Penza, Russia), E-mail: eyutkina@bk.ru 

Index UDK

616-089-07 

DOI

10.21685/2072-3032-2019-3-5 

Abstract

Background. Hernia of the anterior abdominal wall is one of the most common surgical diseases. At the moment, with a large selection of endoprostheses, it is necessary to evaluate the clinical and economic effectiveness of one or another method of surgical intervention. In practice, direct costs do not always correspond to the cost-effectiveness ratio. The goal of our study was to analyze the clinical and economic efficiency of using a combined endoprosthesis and a polypropylene mesh with anti-adhesive coating in intra-abdominal hernioplasty in patients with ventral hernias.
Materials and methods. The work analyzes the results of treatment of 84 patients with ventral hernias. For the patients of the first group undergoing hernioplasty, the custom-developed combined hernioprosthesis consisting of a xenopericardial plate and a polyester mesh (manufactured by Cardioplant LLC) was applied. In the comparison group, surgical treatment was performed using Bard Ventralex composite mesh as a prosthetic material (42 patients). Further, the analysis of early and late postoperative complications was carried out and the comparison of clinical and economic efficacy in the treatment by these methods was carried out.
Results. The conducted economic analysis showed that, despite a longer period of hospitalization, the low price of the combined hernia prosthesis of domestic production fully compensated the material losses incurred. When using different methods of treating patients, it is necessary to analyze their clinical and economic efficacy. It is advisable to analyze the rate of cost-effectiveness increment for a diseasefree and uncomplicated course of the disease.
Conclusions. The clinical and economic efficiency of using the combined hernia-prosthesis in patients with mid ventral hernias is higher than the same indicator when using the composite mesh by 4.7 %. 

Key words

clinical and economic efficacy of hernioplasty, intra-abdominal hernioplasty, ventral hernia hernioplasty, combined herniprosthesis 

Download PDF
References

1. Zakurdaeva M. P. Povyshenie effektivnosti proteziruyushchey gerioplastiki «sublay» v lechenii bol'nykh so sredinnymi posleoperatsionnymi gryzhami: avtoref. dis. kand. med. nauk [Improving the efficiency of “sublay” prosthetic hernioplasty when treating patients with midline post-operative hernias: authors abstract of dissertation to apply for the degree of the candidate of medical sciences]. Voronezh, 2019, 22 p. [In Russian]
2. Arustamyan G. N. Gosudarstvennoe upravlenie. Elektronnyy vestnik [Public administration. Online bulletin]. 2011, no. 29, p. 1. Available at: https://cyberleninka.ru/article/v/kliniko-ekonomicheskiy-analiz-i-ego-rol-v-upravlenii-kachestvommeditsinskoy-pomoschi (accessed 01 Dec. 2011). [In Russian]
3. Shapovalova M. A., Bondarev V. A., Koretskaya L. R. Glavnyy vrach: Khozyaystvo i pravo [Medical superintendant: economy and law]. 2012, no. 3, pp. 4–6. [In Russian]
4. Goryachev D. V. Vedomosti Nauchnogo tsentra ekspertizy sredstv meditsinskogo primeneniya [Bulletin of the Scientific Center of Medical Means Expert Examination]. 2012, no. 3, pp. 61–65. [In Russian]
5. Koretskaya L. R., Shapovalova M. A. Razvitie informatsionnykh tekhnologiy i ikh znachenie dlya modernizatsii sotsial'no-ekonomicheskoy sistemy: materialy Mezhdunar. nauch.-prakt. konf. [Development of information technologies and their importance fro socioeconomic system modernization: proceedings of an International scientific andpractical conference]. Saratov, 2011, pp. 88–89. [In Russian]
6. Ziolkowski N. I., Voineskos S. H., Ignacy T. A., Thoma A. PlastReconstr Surg. 2013, vol. 132, no. 1, pp. 191–203.
7. Otraslevoy standart «Kliniko-ekonomicheskie issledovaniya. Obshchie polozheniya». OST 91500.14.0001–2002. Pravovaya Rossiya. Internet-biblioteka LawRu.Info. Prikaz Minzdrava RF ot 22.10.2003 № 494 «O sovershenstvovanii deyatel'nosti vrachey klinicheskikh farmakologov» [Branch standard “Clinical and economic examination. General provisions”. OST 91500.14.0001–2002. Legal Russia. Online library Law-Ru.Info The order of the Ministry of Healthcare of Russia of 22.10.2003 No 494 “On improvement of clinical pharmacologists’ performance”]. Available at: http://lawru.info/legal2/se14/pravo14864/index.htm (accessed 04 Nov. 2011). [In Russian]
8. Postanovlenie Sovmina SSSR ot 22.10.1990 № 1072 «O edinykh normakh amortizatsionnykh otchisleniy na polnoe vosstanovlenie osnovnykh fondov narodnogo khozyaystva SSSR» [The ordinance of the Council of Ministers of the USSR of 22.10.1990 No 1072 “On uniform standards of amortized allocation for complete recovery of main foundations of the national economy of the USSR”]. Available at: http://www.consultant.ru/ (accessed 05 May 2019). [In Russian]
9. Postanovlenie pravitel'stva RF ot 19.12.2016 № 1403 «O Programme gosudarstvennykh garantiy besplatnogo okazaniya grazhdanam meditsinskoy pomoshchi na 2017 god i na planovyy period 2018 i 2019 godov» [The ordinance of the Government of the Russian Federation of 19.12.2016 No 1403 “On the Program of state guarantees of charge-free medical aid to citizens in 2017 and for the planning period of 2018 and 2019 ”]. Available at: http://base.garant.ru/71572248 /#ixzz5lKS vgCVf [In Russian]
10. Shapovalova M. A., Bondarev V. A., Koretskaya L. R. Glavnyy vrach: Khozyaystvo i pravo [Medical superintendent: Economy and law]. 2012, no. 4, pp. 25–27. [In Russian]

 

Дата создания: 31.10.2019 09:55
Дата обновления: 31.10.2019 10:35