The costs and effects of laparoscopic appendectomy in children.
BACKGROUND
Laparoscopic procedures are performed commonly in children. In general, the cost containment of laparoscopic surgery in children has not been evaluated.


OBJECTIVE
To compare the costs of laparoscopic appendectomy with those of open appendectomy.


METHODS
Prospective clinical trial between November 1, 1997, and April 30, 2000. For analysis, cost of supplies, operation room use, and recovery in the hospital and after discharge was evaluated. Costs common to both groups were not determined.


METHODS
Operations performed in a university hospital.Patients Eighty-seven children aged 4 to 15 years who underwent appendectomy for suspected appendicitis. Patients were randomized to laparoscopic or open appendectomy. Intervention Laparoscopic appendectomies performed with the same standard set of reusable equipment.


METHODS
Cost surplus of the laparoscopic procedure and recovery after surgery were evaluated, to determine the costs and effects of laparoscopic appendectomy compared with those of open appendectomy in children.


RESULTS
Excess operating and complication costs per procedure were 96 euros (EUR) in laparoscopic appendectomy. The increased operative expenses were offset by a shorter hospital stay, resulting in a marginal difference of 53 EUR in itemized total costs between the 2 procedures (total cost, 1023 EUR in the laparoscopic appendectomy group and 970 EUR in the open appendectomy group). After laparoscopic appendectomy, children returned to school and sports earlier than those who had had an open appendectomy.


CONCLUSIONS
Laparoscopic appendectomy was marginally more expensive, but it allowed earlier return to normal daily activities than open appendectomy.
Lintula
Hannu
H
Department of Paediatric Surgery, Kuopio University Hospital, Finland. hannu.lintula@kuh.fi
Kokki
Hannu
H
Vanamo
Kari
K
Valtonen
Hannu
H
Mattila
Matti
M
Eskelinen
Matti
M
D000293:Adolescent; D001062:Appendectomy / Q000009:adverse effects / Q000191:economics* / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005387:Finland; D006801:Humans; D020706:Laparoscopes / Q000191:economics; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics* / Q000379:methods; D011446:Prospective Studies