To compare the application of laparoscopic and open preperitoneal hernia repair in adult inguinal hernia from the perspective of cost-effectiveness.

A total of 132 patients with unilateral inguinal hernia diagnosed and treated in Meishan People's Hospital from January to December 2019 were included. The patients independently selected the surgical methods, including 52 patients in the open operation group and 80 patients in the laparoscopic operation group. The cost calculation included hospitalization expenses, operation expenses and other expenses. The benefit evaluation of patients was carried out using the EuroQuol-5D (EQ-5D) on the 1st day, the 7th day and the 15th day after operation, and the quality-adjusted life years (QALYs) were calculated accordingly. And then calculate the cost-effectiveness ratio (C/E) and the incremental cost-effectiveness ratio (ICER).

The average total cost of the open operation group was ￥7742.72, and the average total cost of the laparoscopic group was ￥12866.56. The QALYs of the open preperitoneal operation group and laparoscopic group were 0.501±0.178/0.692±0.106 on the 1st day, 0.673± 0.123/0.814±0.042 on the 7th day, respectively. The differences were statistically significant. But the QALYs of the patients on the 15th day was 0.809±0.046/0.821±0.040, respectively. The differences were not statistically significant; the ICER of the laparoscopic operation group on the 1st day was ￥3138.76/QALYs; the ICER of the 7th day was ￥4301.8/QALYs; the sensitivity analysis showed that the cost of the C/E change in the laparoscopic group on both the 1st day and the 7th day was material expenses. The critical value analysis showed that if the material cost dropped to ￥5082.32 or ￥3752.68, the C/E of the laparoscopic group and the open group were the same on the 1st day and the 7th day, respectively.

On the 1st and 7th days after laparoscopic inguinal hernia surgery, the quality of life of patients was higher than that of patients undergoing open surgery, and there was no difference between them on the 15th day. Although laparoscopic surgery for inguinal hernia is expensive, the extra cost is "worth" it to improve the quality of life.