Laparoscopic appendectomy, is it worth it?
The recent experience with open appendectomy was compared to our initial experience with laparoscopic appendectomy. Thirty-eight patients had open appendectomy for acute appendicitis. Two major and four minor complications occurred. Concurrently, 39 patients had laparoscopic appendectomy. There was one major and one minor complication. Of the laparoscopic patients, 69% received less than 24 hours of parenteral postoperative analgesia, compared to 44% of the patients in the open group. Fifteen of 39 laparoscopic patients (38%) were discharged within 24 hours of operation versus 3 of 38 (8%) in the open group. Total mean hospital cost for the laparoscopic group, $7,500, was significantly greater than for the open group, $5,700, because of increased laparoscopic equipment charges. Both open and laparoscopic appendectomy procedures were performed with minimal morbidity. The benefits of laparoscopy were earlier hospital discharge and less parenteral analgesic use, but it was significantly more expensive.
Williams
M D
MD
Department of Surgery, University of South Alabama Medical Center, Mobile 36617.
Miller
D
D
Graves
E D
ED
Walsh
C
C
Luterman
A
A
D000208:Acute Disease; D000328:Adult; D000698:Analgesia; D001062:Appendectomy / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D001064:Appendicitis / Q000503:physiopathology / Q000601:surgery*; D004865:Equipment and Supplies, Hospital / Q000191:economics; D005260:Female; D017722:Hospital Charges; D017721:Hospital Costs; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics; D007902:Length of Stay; D008297:Male; D009873:Operating Rooms / Q000191:economics; D010351:Patient Discharge; D001261:Pulmonary Atelectasis / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors