title: Laparoscopic nephrectomy is cost effective compared with open nephrectomy in a large county hospital.
abstract: OBJECTIVE
  To evaluate the experience with laparoscopic nephrectomy in a large county hospital and perform a cost comparison between uncomplicated open and laparoscopic nephrectomy.
  
  
  METHODS
  Eleven consecutive patients who underwent an uncomplicated laparoscopic nephrectomy in a large county hospital were compared with 8 patients who underwent uncomplicated open nephrectomy during the same period. Patient charts and corresponding billing records were reviewed to determine overall hospitalization cost and individual cost components.
  
  
  RESULTS
  No perioperative complications occurred in either the laparoscopic or open group, and no statistically significant differences existed between groups with regard to patient demographics or operative parameters. The overall operating room costs favored the open nephrectomy group by dollars 1070 (P=0.003). However, the overall cost of hospitalization, surgeon professional fees, duration of hospitalization, room and board costs, laboratory, and radiology costs, pharmacy costs, intravenous solution and infusion pump costs all significantly favored the laparoscopic patient group. The mean difference in overall hospital cost between laparoscopic and open nephrectomy was dollars 1211 in favor of laparoscopy (P=0.037).
  
  
  CONCLUSIONS
  Our experience with laparoscopic nephrectomy in a large county hospital demonstrates a clear economic advantage in favor of the laparoscopic approach. Given limited funding for public hospitals and a clear patient benefit, laparoscopic nephrectomy should constitute first-line therapy when nephrectomy is indicated.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center Dallas, Texas 75390, USA.
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Gettman
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Pearle
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cadeddu
mesh_terms: D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006766:Hospitals, County; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000191:economics* / Q000379:methods; D009873:Operating Rooms / Q000191:economics