title: Laparoscopic versus standard appendectomy outcomes and cost comparisons in the private sector.
abstract: Minimally invasive surgery has been proposed as the preferred treatment strategy for various gastrointestinal disorders due to shorter hospital stay, less pain, quicker return to normal activities, and improved cosmesis. However, these advantages may not be straightforward for laparoscopic appendectomy, and optimal management of remains controversial. One hundred forty-eight patients with clinical and radiologic diagnoses of acute appendicitis treated in two different hospitals were retrospectively reviewed. Seventy-eight patients underwent laparoscopic appendectomy in hospital A and 70 patients underwent standard appendectomy in hospital B. Patients treated by either type of surgery were compared in terms of clinical and pathologic features, operation characteristics, complications, and costs. There were no significant differences between both groups in terms of clinical features, radiologic studies, complications, and final pathology findings (P > .05). Hospital stay was significantly shorter and bowel movements recovered quicker in the laparoscopy group. However, overall and operating room costs were significantly higher in patients treated by laparoscopy (P < .01). Our series show a subtle difference in terms of hospital stay and bowel movement recovery, favoring patients treated by laparoscopy. However, these results have to be carefully examined and weighed, because overall costs and operating room costs were significantly higher in the laparoscopy group.
authors.affiliation: Department of Gastroenterology, Laparoscopic Surgery Unit, University of São Paulo, School of Medicine, São Paulo, Brazil. cbresciani@ig.com.br
authors.forename: Cláudio
authors.initials: C
authors.lastname: Bresciani
authors.forename: Rodrigo Oliva
authors.initials: RO
authors.lastname: Perez
authors.forename: Angelita
authors.initials: A
authors.lastname: Habr-Gama
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Jacob
authors.forename: Alberto
authors.initials: A
authors.lastname: Ozaki
authors.forename: Carlos
authors.initials: C
authors.lastname: Batagello
authors.forename: Igor
authors.initials: I
authors.lastname: Proscurshim
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gama-Rodrigues
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000191:economics* / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D011183:Postoperative Complications; D017149:Private Sector; D012189:Retrospective Studies; D016896:Treatment Outcome