Skip to main content
Log in

Laparoscopic versus standard appendectomy outcomes and cost comparisons in the private sector

  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Minimally invasive surgery has been proposed as the preferred treatment strategy for various gastrointestinal disorders due to shorter hospital stay, less pain, quicker return to normal activities, and improved cosmesis. However, these advantages may not be straightforward for laparoscopic appendectomy, and optimal management of remains controversial. One hundred forty-eight patients with clinical and radiologic diagnoses of acute appendicitis treated in two different hospitals were retrospectively reviewed. Seventy-eight patients underwent laparoscopic appendectomy in hospital A and 70 patients underwent standard appendectomy in hospital B. Patients treated by either type of surgery were compared in terms of clinical and pathologic features, operation characteristics, complications, and costs. There were no significant differences between both groups in terms of clinical features, radiologic studies, complications, and final pathology findings (P > .05). Hospital stay was significantly shorter and bowel movements recovered quicker in the laparoscopy group. However, overall and operating room costs were significantly higher in patients treated by laparoscopy (P < .01). Our series show a subtle difference in terms of hospital stay and bowel movement recovery, favoring patients treated by laparoscopy. However, these results have to be carefully examined and weighed, because overall costs and operating room costs were significantly higher in the laparoscopy group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Oldham KT. Financial considerations in laparoscopic and open appendectomy. Arch Pediatr Adolesc Med 2004;158:11–12.

    Article  PubMed  Google Scholar 

  2. Holcomb GW 3rd, Morgan WM 3rd, Neblett WW 3rd, Pietsch JB, O’Neill JA Jr, Shyr Y. Laparoscopic cholecystectomy in children: lessons learned from the first 100 patients. J Pediatr Surg 1999;34:1236–1240.

    Article  PubMed  Google Scholar 

  3. Glasgow RE, Fingerhut A, Hunter J. SAGES Appropriateness Conference: a summary. Surg Endosc 2003;17:1729–1734.

    Article  PubMed  CAS  Google Scholar 

  4. Vernon AH, Georgeson KE, Harmon CM. Pediatric laparoscopic appendectomy for acute appendicitis. Surg Endosc 2004;18:75–79.

    Article  PubMed  CAS  Google Scholar 

  5. Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2004: CD001546.

  6. Garbutt JM, Soper NJ, Shannon WD, Botero A, Littenberg B. Meta-analysis of randomized controlled trials comparing laparoscopic and open appendectomy. Surg Laparosc Endosc 1999;9:17–26.

    Article  PubMed  CAS  Google Scholar 

  7. Chung RS, Rowland DY, Li P, Diaz J. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg 1999;177:250–256.

    Article  PubMed  CAS  Google Scholar 

  8. Sauerland S, Lefering R, Holthausen U, Neugebauer EA. Laparoscopic vs conventional appendectomyda metaanalysis of randomised controlled trials. Langenbecks Arch Surg 1998;383:289–295.

    Article  PubMed  CAS  Google Scholar 

  9. Guller U, Hervey S, Purves H, Muhlbaier LH, Peterson ED, Eubanks S, et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg 2004;239:43–52.

    Article  PubMed  Google Scholar 

  10. Cariati A, Brignole E, Tonelli E, Filippi M, Guasone F, De Negri A, et al. [Laparoscopic or open appendectomy. Critical review of the literature and personal experience]. G Chir 2001;22:353–357.

    PubMed  CAS  Google Scholar 

  11. Williams MD, Collins JN, Wright TF, Fenoglio ME. Laparoscopic versus open appendectomy. South Med J 1996;89:668–674.

    Article  PubMed  CAS  Google Scholar 

  12. Fallahzadeh H. Should a laparoscopic appendectomy be done? Am Surg 1998;64:231–233.

    PubMed  CAS  Google Scholar 

  13. Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990;132:910–925.

    PubMed  CAS  Google Scholar 

  14. Samelson SL, Reyes HM. Management of perforated appendicitis in childrendrevisited. Arch Surg 1987;122:691–696.

    PubMed  CAS  Google Scholar 

  15. A sound approach to the diagnosis of acute appendicitis. Lancet 1987;1:198-200.

  16. Tang E, Ortega AE, Anthone GJ, Beart RW Jr. Intraabdominal abscesses following laparoscopic and open appendectomies. Surg Endosc 1996;10:327–328.

    Article  PubMed  CAS  Google Scholar 

  17. Maxwell JG, Robinson CL, Maxwell TG, Maxwell BG, Smith CR, Brinker CC. Deriving the indications for laparoscopic appendectomy from a comparison of the outcomes of laparoscopic and open appendectomy. Am J Surg 2001;182:687–692.

    Article  PubMed  CAS  Google Scholar 

  18. Fingerhut A, Millat B, Borrie F. Laparoscopic versus open appendectomy: time to decide. World J Surg 1999;23:835–845.

    Article  PubMed  CAS  Google Scholar 

  19. Eriksson S, Granstrom L. Randomized controlled trial of appendicectomy versus antibiotic therapy for acute appendicitis. Br J Surg 1995;82:166–169.

    Article  PubMed  CAS  Google Scholar 

  20. Slim K, Pezet D, Chipponi J. Laparoscopic or open appendectomy? Critical review of randomized, controlled trials. Dis Colon Rectum 1998;41:398–403.

    Article  PubMed  CAS  Google Scholar 

  21. Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a metaanalysis. J Am Coll Surg 1998;186:545–553.

    Article  PubMed  CAS  Google Scholar 

  22. Ramesh S, Galland RB. Early discharge from hospital after open appendicectomy. Br J Surg 1993;80:1192–1193.

    Article  PubMed  CAS  Google Scholar 

  23. Lord RV, Sloane DR. Early discharge after open appendicectomy. Aust N Z J Surg 1996;66:361–365.

    PubMed  CAS  Google Scholar 

  24. Millat B, Fingerhut A, Gignoux M, Hay JM. Factors associated with early discharge after inguinal hernia repair in 500 consecutive unselected patients. French Assoc Surg Res. Br J Surg 1993;80:1158–1160.

    Article  PubMed  CAS  Google Scholar 

  25. Ignacio RC, Burke R, Spencer D, Bissell C, Dorsainvil C, Lucha PA. Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc 2004;18:334–337.

    Article  PubMed  CAS  Google Scholar 

  26. McKinlay R, Mastrangelo MJ Jr. Current status of laparoscopic appendectomy. Curr Surg 2003;60:506–512.

    Article  PubMed  Google Scholar 

  27. Cariati A, Masini R. Hospital bill in open and laparoscopic appendectomy. Ann Surg 2004;240:562–563. author reply 563, 2004.

    Article  PubMed  Google Scholar 

  28. Vallina VL, Velasco JM, McCulloch CS. Laparoscopic versus conventional appendectomy. Ann Surg 1993;218:685–692.

    Article  PubMed  CAS  Google Scholar 

  29. Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg 2002;137:799–804; discussion 804, 2002.

    Article  PubMed  Google Scholar 

  30. Nguyen NT, Zainabadi K, Mavandadi S, Paya M, Stevens CM, Root J, et al. Trends in utilization and outcomes of laparoscopic versus open appendectomy. Am J Surg 2004;188:813- 820.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cláudio Bresciani M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bresciani, C., Perez, R.O., Habr-Gama, A. et al. Laparoscopic versus standard appendectomy outcomes and cost comparisons in the private sector. J Gastrointest Surg 9, 1174–1181 (2005). https://doi.org/10.1016/j.gassur.2005.06.001

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1016/j.gassur.2005.06.001

Key words

Navigation