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Retroperitoneal endoscopic versus conventional open adrenalectomy: a cost-effectiveness analysis
Jennifer M J Schreinemakers1, Sjoerd G Elias, Inne H M Borel Rinkes
1Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Background:
A retrospective cost-effectiveness analysis was carried out, comparing retroperitoneal endoscopic and conventional adrenalectomy, which is based on a large group of patients, restricted in tumor size for the purpose of ensuring comparability.
Materials And Methods:
Between 1990 and 2004, 61 patients underwent either an endoscopic or open adrenalectomy for tumors smaller than 6 cm. A short-term, base cost-effectiveness analysis was performed to evaluate costs per day prevented, and a sensitivity analysis was calculated.
Results:
Average recovery time, postoperative stay, and resumption to oral intake were significantly shorter in the endoscopic group, whereas operative time was longer. No major complications occurred in either group. In 3 endoscopic procedures conversion was indicated. The base cost-effectiveness ratio was 15.41 per day postoperative stay prevented by the endoscopic approach. The number needed to treat with endoscopic adrenalectomy to prevent 1 week of postoperative stay is 2.
Conclusion:
Retroperitoneal endoscopic adrenalectomy may be considered a cost-effective procedure, compared to the conventional open adrenalectomy.
