title: Comparison of clinical outcomes and hospital cost between open appendectomy and laparoscopic appendectomy.
abstract: OBJECTIVE
  Laparoscopic appendectomy has been recognized to have many advantages such as greater cosmetic results, less postoperative pain and shorter hospital stays. On the other hand, the cost of laparoscopic procedures is still more expensive than that of open procedures in Korea. The aim of this study is to compare clinical outcomes and hospital costs between open appendectomy and laparoscopic appendectomy.
  
  
  METHODS
  Between January 1, 2010 and December 31, 2010, 471 patients were diagnosed with acute appendicitis. Of these, 418 patients met the inclusion criteria and were divided into two groups of open appendectomy (OA) group and laparoscopic appendectomy (LA) group. We analyzed the clinical data and hospital costs.
  
  
  RESULTS
  The mean operation time for laparoscopic appendectomy (72.17 minutes) was significantly longer than that of open appendectomy (46.26 minutes) (P = 0.0004). The mean amounts of intravenous analgesics for OA group (2.00 times) was greater than that of LA group (1.86 times) (P < 0.0001). The complication rate was similar between the two groups (OA, 6.99% vs. LA, 10.87%; P = 0.3662). The mean length of postoperative hospital stay was shorter in LA group (OA, 4.55 days vs. LA, 3.60 days; P = 0.0002). The mean total cost covered by the National Health Insurance was more expensive in LA group (OA, 1,259,842 won [Korean monetary unit] vs. LA, 1,664,367 won; P = 0.0057).
  
  
  CONCLUSIONS
  Clinical outcomes of laparoscopic appendectomy were superior to that of open appendectomy even though the cost of laparoscopic appendectomy was more expensive than that of open appendectomy. Whenever surgeons manage a patient with appendicitis, laparoscopic appendectomy should be considered as the procedure of choice.
authors.affiliation: Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Ho Jun
authors.initials: HJ
authors.lastname: Lee
authors.forename: Yong Hwan
authors.initials: YH
authors.lastname: Park
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Kim
authors.forename: Pyong Wha
authors.initials: PW
authors.lastname: Choi
authors.forename: Je Hoon
authors.initials: JH
authors.lastname: Park
authors.forename: Tae Gil
authors.initials: TG
authors.lastname: Heo
authors.forename: Myung Soo
authors.initials: MS
authors.lastname: Lee
authors.forename: Chul Nam
authors.initials: CN
authors.lastname: Kim
authors.forename: Surk Hyo
authors.initials: SH
authors.lastname: Chang