Transumbilical laparoscopic-assisted appendectomy is associated with lower costs compared to multiport laparoscopic...

Area of Science:

• Minimally Invasive Surgery
• Pediatric Surgery
• Health Economics

Background:

• Single-incision laparoscopic appendectomy offers cosmetic and pain benefits.
• Limited data exists on cost-effectiveness and other outcomes of single-incision techniques.

Purpose of the Study:

• To compare costs and outcomes of transumbilical laparoscopic-assisted appendectomy (TULAA) and multiport laparoscopic appendectomy (MLA).

Main Methods:

• Retrospective review of 372 pediatric patients (September 2010-July 2013).
• Outcomes assessed: costs, length of stay (LOS), and readmission.
• Generalized linear regression used for cost analysis; subgroup analysis for non-perforated appendicitis.

Main Results:

• TULAA (132 patients) showed decreased operative time (0.6 vs. 1.0h) compared to MLA (240 patients).
• TULAA was used less for perforated appendicitis (9.8% vs. 22.9%).
• For non-perforated appendicitis, TULAA resulted in lower costs ($1378 less than MLA) with similar readmission and complication rates.

Conclusions:

• Transumbilical laparoscopic-assisted appendectomy (TULAA) is associated with reduced costs in non-perforated appendicitis.
• TULAA demonstrates comparable readmission and postoperative complication rates to multiport laparoscopic appendectomy (MLA).