Laparoscopic versus open appendicectomy in Greek reality

Area of Science:

• General Surgery
• Minimally Invasive Surgery

Background:

• Acute appendicitis is a common surgical emergency.
• Laparoscopic appendicectomy (LA) is increasingly adopted worldwide.
• The economic and clinical implications of LA in Greece require evaluation.

Purpose of the Study:

• To assess the efficacy and cost-effectiveness of laparoscopic appendicectomy (LA) compared to open appendicectomy (OA) in Greece.
• To analyze hospital stay, morbidity, and cost associated with both surgical approaches.

Main Methods:

• Retrospective analysis of 135 patients undergoing surgery for acute appendicitis.
• Comparison between laparoscopic appendicectomy (n=57) and open appendicectomy (n=78).
• Evaluation of appendicitis severity, complication rates, hospital stay, and procedural costs.

Main Results:

• No significant difference in appendicitis severity (P = 0.667) between LA and OA groups.
• Similar complication rates (P = 0.414) and mean hospital stay (LA = 3.18 days vs. OA = 2.97 days, P = 0.664) were observed.
• Mean net cost for LA was €1320.60, significantly higher than OA at €237.80, due to Greek pricing structures.

Conclusions:

• Laparoscopic appendicectomy is a viable option for acute appendicitis, irrespective of severity.
• The high cost of LA in Greece, driven by an insufficient costing system, impacts its cost-effectiveness.
• Cost-effectiveness of LA is currently optimized for specific demographics (young women, obese men) within the existing Greek healthcare economic model.