title: Clinical outcome and cost comparison between laparoscopic and open appendicectomy.
abstract: BACKGROUND
  Local data comparing laparoscopic appendicectomy (LA) and open appendicectomy (OA) is lacking. We perform a cost and outcome comparison between LA and OA.
  
  
  METHODS
  A retrospective review of all appendicectomies performed for suspected appendicitis from July 2010 to December 2010 was conducted. Patient demographics, duration of surgery, complication rates, total cost of stay (COS) and length of stay (LOS) were compared between LA and OA.
  
  
  RESULTS
  A total of 198 patients underwent appendicectomy during the duration of study; 82 LA and 116 OA. There were 115 males (58.1%) and 83 females (41.9%). Median age was 33 years. Patients who underwent LA were significantly younger (P <0.001) with a greater proportion of females (P <0.0001) and were more likely to be negative appendicectomies (18.3% vs. 6.9%, P = 0.023). Duration of surgery was significantly longer in LA patients (86 min vs. 74 min, P = 0.003). LOS in the LA group was shorter by 1.3 days compared to OA (2.0 days vs. 3.3 days, P <0.0001). The differences in operative duration and LOS between LA and OA remained significant on multivariate analysis (P = 0.001 and P = 0.008, respectively). The COS (P = 0.359), wound infection rates (P = 0.528) and complication rates (P = 0.131) were not significantly different between the 2 groups.
  
  
  CONCLUSIONS
  LA is associated with a shorter LOS while its cost is equivalent to OA. From the perspective of utilisation of healthcare resources, LA appears to be superior.
authors.affiliation: Department of General Surgery, Singapore General Hospital, Singapore.
authors.forename: Winson J H
authors.initials: WJ
authors.lastname: Tan
authors.forename: Wansze
authors.initials: W
authors.lastname: Pek
authors.forename: Tousif
authors.initials: T
authors.lastname: Kabir
authors.forename: Weng Hoong
authors.initials: WH
authors.lastname: Chan
authors.forename: Wai Keong
authors.initials: WK
authors.lastname: Wong
authors.forename: Hock Soo
authors.initials: HS
authors.lastname: Ong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000191:economics* / Q000379:methods*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult