title: Laparosocopic Appendectomy, Cost-Effectiveness of Three Different Techniques Used to Close the Appendix Stump.
abstract: It is generally agreed that laparoscopic appendectomy is a valuable operative method. The aim of the study was to evaluate cost-effectiveness of three different techniques used to close the appendix stump.
  
  
  METHODS
  We conducted a retrospective study that compared three groups of patients who were operated on laparoscopically for acute appendicitis in 2013 at our institution. We used an endoscopic clip to close the appendix stump in the first group (n=20), endoscopic stapler was applied in the second group (n=20), and in the third group of patients the appendix base was closed with a laparoscopic suture (n=20). These groups were matched by age, sex and BMI.
  
  
  RESULTS
  The average operative cost was the highest in the second group. Cost of the laparoscopic appendectomy with the application of the endoscopic clip was significantly lower (first group) and comparable to the third group. Observed differences in total hospitalization costs were associated only with the chosen appendix stump closure technique.
  
  
  CONCLUSIONS
  Clip closure of the appendix base is an easy and cost-effective procedure. The laparoscopic suture technique is the cheapest but technically demanding. According to our experience endoscopic stapler may be useful in some cases, although it is the most expensive method.
authors.forename: Maciej
authors.initials: M
authors.lastname: Matyja
authors.forename: Marcin
authors.initials: M
authors.lastname: Strzałka
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Rembiasz
mesh_terms: D001062:Appendectomy / Q000191:economics* / Q000295:instrumentation / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D001065:Appendix / Q000601:surgery*; D003362:Cost-Benefit Analysis; D006801:Humans; D010535:Laparoscopy / Q000191:economics* / Q000295:instrumentation / Q000379:methods*; D011044:Poland; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000191:economics; D017792:Surgical Stapling / Q000191:economics; D013537:Sutures / Q000191:economics