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Cost Comparison between Laparoscopic and Open Appendectomies in Children
Shahzad Y Khan1, Zainab N Al-Balushi, Khalid M Bhatti
1Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman.
Insights
Laparoscopic appendectomy (LA) in children is more expensive than open appendectomy (OA) but offers similar safety and hospital stay duration. Cost-effective techniques for LA are being explored.
Area of Science:
- Pediatric surgery
- Surgical outcomes
- Health economics
Background:
- Laparoscopic appendectomy (LA) is a popular procedure for acute appendicitis in children.
- The cost-effectiveness of surgical interventions is a significant consideration for healthcare providers and patients.
Purpose of the Study:
- To compare the total costs of open appendectomy (OA) versus LA in pediatric patients.
- To explore cost-effective strategies for pediatric appendectomy procedures.
Main Methods:
- Retrospective review of medical records for children aged 0-12 years undergoing OA or LA.
- Comparison of operative time, hospital stay, cost, and complication rates between the two groups.
Main Results:
- LA procedures were performed on 75 patients, while OA was performed on 34.
- Average operative time was longer for LA (76 min) than OA (49 min).
- Average cost was higher for LA (OMR 534) compared to OA (OMR 343), with lower complication rates for LA (8% vs 11.7%).
Conclusions:
- Laparoscopic appendectomy is more costly than open appendectomy in children.
- LA is as safe as OA, with no significant increase in morbidity or hospital stay.
- Further research into cost-reduction techniques for LA is warranted.
Objectives:
Laparoscopic appendectomy (LA) for children has become very popular and is routinely performed in most health care centres around the world. The cost of surgical procedures is always a concern for patients and health care providers. This study compares, the total cost of open appendectomy (OA) with LA in children who required an appendectomy for acute appendicitis. Suitable and safe cost-effective techniques were also explored to reduce the cost of these procedures.
Methods:
The medical records of all the children (ranging between 0 and 12 years) at Sultan Qaboos University Hospital in Oman, who required OA or LA from June 2009 to July 2011, were reviewed.
Results:
LA were performed in 75 patients while OA were done in 34. Patients from the OA and LA groups were age- and gender-matched. The average operative time was 76 minutes for LA and 49 minutes for OA (P <0.001) while the average hospital stay was 3.14 days for LA and 2.15 days for OA (P = 0.08). The average cost of the two procedures was Omani riyals (OMR) 534 for LA and OMR 343 for OA (P = 0.00). The complication rate following procedures was lower in the case of LA, however this was not statistically significant (LA = 8% versus OA = 11.7 %, P = 0.32).
Conclusion:
LA are costlier procedures than OA, however they are as safe as OA, and do not increase morbidity or the duration of hospital stay.
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