title: A comparative cost analysis study of lobectomy performed via video-assisted thoracic surgery versus thoracotomy in Turkey.
abstract: BACKGROUND
  Cost analysis studies performed in western countries report that the overall cost of lobectomies performed via video-assisted thoracic surgery is similar to or less than those performed via thoracotomy. The situation may be different in a developing country.
  
  
  OBJECTIVE
  We evaluated the cost differences of these two surgical methods.
  
  
  METHODS
  We retrospectively reviewed the hospital records of 81 patients who underwent lobectomy either via video-assisted thoracic surgery (n = 32) or via thoracotomy (n = 49). Patient characteristics, pathology, perioperative complications, additional surgical procedures, length of hospital and intensive care unit stay, and outcomes of both groups were recorded. Detailed cost data for medications, anesthesia, laboratory, surgical instruments, disposable instruments and surgery cost itself were also documented. Statistical analyses were performed to compare the groups.
  
  
  RESULTS
  The two groups were homogeneous in regard to age, sex, pathology and perioperative morbidity. The mean duration of hospitalization in the video-assisted thoracic surgery group was significantly shorter than that of the thoracotomy group (7.78 ±5.11 days vs. 10.65 ±6.57 days, p < 0.05). Overall final mean cost in the video-assisted thoracic surgery group was significantly higher than that of the thoracotomy group ($3970 ±1873 vs. $3083 ±1013, p = 0.002). This significant difference relies mostly on the cost of disposable surgical instruments, which were used much more in the video-assisted thoracic surgery group than the thoracotomy group ($2252 ±1856 vs. $427 ±47, p < 0.05).
  
  
  CONCLUSIONS
  In contrast to western countries, a video-assisted thoracic surgical lobectomy may cost more than a lobectomy via thoracotomy in a developing country. More expensive disposable surgical instruments and cheaper hospital stay charges lead to higher overall costs in video-assisted thoracic surgical lobectomy patients.
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, Istanbul, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Alpay
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, Istanbul, Turkey.
authors.forename: Tunc
authors.initials: T
authors.lastname: Lacin
authors.affiliation: Faculty of Economics and Administrative Sciences, Okan University, Istanbul, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Teker
authors.affiliation: Department of Thoracic Surgery, Acibadem Hospital, Istanbul, Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Okur
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, Istanbul, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Baysungur
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, Istanbul, Turkey.
authors.forename: Serda
authors.initials: S
authors.lastname: Kanbur
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, Istanbul, Turkey.
authors.forename: Aysun Kosif
authors.initials: AK
authors.lastname: Misirlioglu
authors.affiliation: Department of Thoracic Surgery, Sultanbeyli Hospital, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Sonmez
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, Istanbul, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Yalcinkaya
authors.affiliation: Faculty of Economics and Administrative Sciences, Okan University, Istanbul, Turkey.
authors.forename: Mithat
authors.initials: M
authors.lastname: Kiyak
keywords: lobectomy; thoracotomy; video-assisted thoracic surgery