Comparison of clinical outcomes and hospital cost between open appendectomy and laparoscopic appendectomy
이호준, 박용환, 김재일, 최평화, 박제훈, 허태길, 이명수, 김철남, 장석효,
소속 상세정보
이호준 ( Lee Ho-Jun )
Inje University College of Medicine Department of Surgery
박용환 ( Park Yong-Hwan )
Inje University College of Medicine Department of Surgery
김재일 ( Kim Jae-Il )
Inje University College of Medicine Department of Surgery
최평화 ( Choi Pyong-Wha )
Inje University College of Medicine Department of Surgery
박제훈 ( Park Je-Hoon )
Inje University College of Medicine Department of Surgery
허태길 ( Heo Tae-Gil )
Inje University College of Medicine Department of Surgery
이명수 ( Lee Myung-Soo )
Inje University College of Medicine Department of Surgery
김철남 ( Kim Chul-Nam )
Inje University College of Medicine Department of Surgery
장석효 ( Chang Surk-Hyo )
Inje University College of Medicine Department of Surgery
KMID : 0371320110810050321
Abstract
Purpose: 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).
Conclusion: 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.
키워드
Appendicitis; Appendectomy; Hospital costs; Clinical outcomes
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