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Costs of videothoracoscopic surgery versus open resection for patients with of lung carcinoma
J Nakajima1, S Takamoto, T Kohno
1Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo, Japan. nakajima-tho@h.u-tokyo-ac.jp
Background:
The costs of videothoracoscopic procedures for patients with lung carcinoma were compared with those of patients who underwent open thoracotomy in Japan.
Methods:
The cost of surgical treatment in 1997 and 1998 for patients with resectable primary or metastatic lung carcinoma was analyzed from itemized statements of hospital charges. For patients with lung carcinoma who are in relatively poor health, the authors chose videothoracoscopic lobectomy or partial resection of the lung instead of an open thoracotomy. For patients with solitary pulmonary metastasis, the authors routinely performed thoracoscopic partial resection of the lung.
Results:
Among 102 patients who were selected for the analysis, 79 patients had primary lung carcinoma, and 23 had metastatic lung carcinoma. Sixty-six open thoracotomies and 36 thoracoscopic surgeries were performed. The mean hospital charge for the entire group of patients was $11,348 (U.S.). The total charges accrued in the operating room amounted to 63% of the hospital charges. Hospitalization was significantly shorter in the group of patients who underwent videothoracoscopy (17.3 days) compared with the group of patients who underwent open thoracotomy (23.8 days). The charges for laboratory examinations, anesthesia, disposable equipment, and hospitalization were significantly higher in patients who underwent open thoracotomy compared with the patients who underwent videothoracoscopy. There were no statistically significant differences in the charges for medication or surgical fees between the two groups.
Conclusions:
The hospital charges for patients undergoing videothoracoscopic surgery were lower than the charges for patients undergoing open thoracotomy at the authors' hospital. The lower cost was attributable mainly to the less invasive nature of thoracoscopic surgical procedures, which also may be beneficial for decreasing the risk of postsurgical complications in patients in who are in relatively poor health.