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Laparoscopic and open partial nephrectomy: cost comparison with analysis of individual parameters
Sangtae Park1, Margaret S Pearle, Jeffrey A Cadeddu
1Department of Urology, University of Washington, Seattle, Washington, USA.
Journal of Endourology
|January 12, 2008
Summary
Laparoscopic partial nephrectomy (LPN) can be as cost-effective as open partial nephrectomy (OPN) for small renal masses. Monitoring operating room time, length of stay, and equipment costs is key to achieving cost equivalence.
Area of Science:
- Urology
- Surgical Oncology
- Health Economics
Background:
- Laparoscopic partial nephrectomy (LPN) offers reduced morbidity compared to open partial nephrectomy (OPN).
- The adoption of new technologies in LPN may increase procedural costs.
- A comprehensive cost comparison between LPN and OPN is essential.
Purpose of the Study:
- To compare the overall costs of LPN and OPN.
- To identify cost drivers and perform sensitivity analyses for LPN and OPN.
Main Methods:
- Literature review to extract data on operating room (OR) time, equipment use, and length of stay (LOS).
- Development of decision tree models to estimate costs for OPN and LPN scenarios (reusable, disposable, hand-assist equipment).
- One-way and two-way sensitivity analyses to assess the impact of variable cost components.
Main Results:
- Analysis of 12 OPN and 13 LPN articles (574 and 949 patients, respectively).
- LPN demonstrated significantly shorter LOS (2.9 days) vs. OPN (5.7 days) (P<0.001).
- The LPN model with disposable equipment was less costly ($8019) than OPN ($8450), driven by shorter LOS.
Conclusions:
- LPN can achieve cost equivalence with OPN for small renal masses.
- Cost-effectiveness is contingent on monitoring OR time, LOS, and equipment expenses.
- Shorter LOS and reduced OR time can offset the higher costs of LPN technologies.
