Background: The components separation technique (CST) is performed through an open or endoscopic approach. It is unclear whether the costs associated with the endoscopic instruments outweigh any clinical benefit derived from their use and the avoidance of lipocutaneous flaps. This study aimed to compare the direct costs associated with each approach.
Methods: A retrospective review of patients undergoing open or endoscopic CST between 2005 and 2009 was performed. The review compared patient-related variables, length of hospital stay, wound morbidity, and costs associated with the index operation and encounters within a 6-month period.
Results: Of the 54 patients identified, 59% underwent endoscopic repair, and 41% had an open CST repair. The patients were similar in age, American Society of Anesthesiology (ASA) score, gender, body mass index (BMI), number of prior surgeries, active abdominal infection, defect size, operating room time, and length of hospital stay. The overall median direct costs were similar between endoscopic and open CST ($9,942 vs. $17,701; p = 0.09). No difference was detected in median operating room costs, but an approximate $7,000 difference was noted between endoscopic and open CST ($1,871 vs. $8,705; p = 0.96). The median mesh costs differed significantly between endoscopic and open CST ($733 vs. $8,415; p = 0.05) as did stapler use costs ($35 vs. $190; p = 0.002). The median cost of endoscopic instruments was $848. Open CST had a 41% major wound morbidity rate compared with 19% in the endoscopic group (p = 0.07). Most of the encounters in the 6-month follow-up period (85%) were related to wound morbidity. The median cumulative direct costs differed between endoscopic and open CST at 3 and 6 months ($12,528 vs. $20,326; p = 0.05).
Conclusions: In a similarly complex group of patients, the total direct costs associated with endoscopic and open CST were similar. Endoscopic instruments made a marginal contribution to the total overall costs, but significant cost contributors were the use of biologic grafts and wound morbidity.
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http://dx.doi.org/10.1007/s00464-010-1526-8 | DOI Listing |
Mar Pollut Bull
December 2024
Extreme Materials Research Center, Korea Institute of Science and Technology (KIST), Seoul 02792, Republic of Korea; Korea Institute of Science and Technology - Sungkyunkwan University Carbon-Neutral Research Center, Sungkyunkwan University (SKKU), Suwon 16419, Republic of Korea; School of Chemical Engineering, Sungkyunkwan University (SKKU), Suwon 16419, Republic of Korea. Electronic address:
Oil spill accidents have series environmental and economic impacts, increasing the demand for efficient technologies to recover oil from contaminated waters. In this study, a hierarchically structured ratchet surface with superhydrophilicity was presented as a novel oil skimming mechanism for the recovery of high-viscosity oil, particularly low-sulfur fuel oil (LSFO), which has recently been used as marine fuel in open water environments. The interaction between the superhydrophilic ratchet and oil provides favorable conditions for oil retention at the water surface.
View Article and Find Full Text PDFIntroduction: White matter tracts that connect different parts of the brain comprise the structural connectome, which is essential to its operation. Assessing behavioral changes and brain health requires an understanding of these tracts. Diffusion tensor imaging (DTI), in particular, allows for the thorough viewing and characterization of these routes in tractography.
View Article and Find Full Text PDFTransl Vis Sci Technol
December 2024
Opthea Limited, Melbourne, Victoria, Australia.
Purpose: Sozinibercept inhibits vascular endothelial growth factors (VEGFs) C and D. This study evaluated outcomes following switching from anti-VEGF-A monotherapy to intravitreal injections of three dose levels of sozinibercept in combination with aflibercept in patients with diabetic macular edema (DME).
Methods: A phase 1b, open-label, multicenter dose-escalation study with a 24-week follow-up.
Cureus
November 2024
Ophthalmology, Gandhi Medical College and Hamidia Hospital, Bhopal, IND.
Diabetic macular oedema (DME) is a major cause of vision impairment in individuals with diabetes mellitus, characterised by fluid accumulation in the macula due to increased vascular permeability. The growing prevalence of diabetes worldwide has led to an increasing burden of DME on healthcare systems. While current treatment options such as anti-vascular endothelial growth factor (anti-VEGF) injections, corticosteroids, and laser therapy exist, the variability in patient responses highlights the need for reliable prognostic tools.
View Article and Find Full Text PDFCureus
October 2024
Anesthesiology, Unidade Local de Saúde do Alto Ave, Guimarães, PRT.
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